Diabetes: weight loss may not always be a good thing

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While weight loss reduces the long-term risk for cardiovascular disease and mortality for the majority of patients with type 2 diabetes (T2D), for a small subgroup, weight-loss intervention may lead to dramatically worse outcomes. 

That’s according to the authors of a new study published in The Lancet Diabetes & Endocrinology, who utilised machine-learning techniques to analyse data from the Look AHEAD (Action for Health in Diabetes) trial, which was halted in 2012 because its results did not reach statistical significance.

While 85 percent of the study sample did experience a clinically meaningful, significant reduction in cardiovascular mortality and morbidity during an intensive weight loss intervention, 15 per cent of participants with well-controlled diabetes and poor self-reported general health experienced negative effects that rendered the overall study outcome neutral. The subgroup also reported substantially poorer compliance with the exercise portion of the intervention and experienced less improvement in several intermediate health outcome.

The authors suggest that HbA1c levels and a short questionnaire on general health might identify people with type 2 diabetes who are likely to derive most benefit from an intensive lifestyle intervention aimed at weight loss.