Beneficial effect of moderate weight loss in older patients with non-insulin-dependent diabetes mellitus poorly controlled with insulin.
Fifteen patients with non-insulin-dependent diabetes mellitus, poorly controlled on insulin, were enrolled in a weight loss program. Criteria included a fasting plasma glucose concentration greater than 200 mg/dl, age in excess of 65 years, and the presence of obesity. Twelve of the 15 patients were able to complete the program, and the average weight loss of the group was 9 kg. Prior to initiation of the weight loss program the 12 patients were receiving (mean +/- SEM) 52 +/- 5 units of insulin per day and had a mean (+/- SEM) fasting plasma glucose concentration of 258 +/- 10 mg/dl. Insulin treatment was discontinued in all subjects during the weight loss period, and did not need to be resumed when weight stabilization had occurred. On the other hand, reasonable diabetic control could not be maintained without medication, and all patients were started on chlorpropamide during the period of weight stabilization. With this approach, a mean (+/- SEM) fasting glucose concentration of 137 +/- 4 mg/dl was achieved with a daily chlorpropamide dose of 354 +/- 30 mg. This dramatic clinical change took place despite the fact that no patient achieved ideal body weight. These results document the ability of a moderate amount of weight loss to transform patients with non-insulin-dependent diabetes mellitus, who are overweight and older than 65 years of age, from treatment failures to treatment successes.
D000368:Aged; D001835:Body Weight; D002747:Chlorpropamide / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000188:drug therapy; D003927:Diet, Diabetic; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000209:etiology; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D009765:Obesity / Q000150:complications / Q000178:diet therapy*
D007328:Insulin; D002747:Chlorpropamide