title: Diabetes disease stage predicts weight loss outcomes with long-term appetite suppressants.
abstract: OBJECTIVE
  Characterize degree of weight loss with stage of diabetes and describe its effect on cardiovascular disease risk factors in obese patients with and without diabetes.
  
  
  METHODS
  Retrospective cohort analysis from patients participating in a long-term weight management protocol using diet, exercise, behavioral modification, and appetite-suppressant therapy. Patient groups, with (n = 19) and without diabetes (n = 19) were matched for age, gender, and weight before weight loss therapy. The effect of 12 months of therapy on weight, blood pressure, glycemic control, lipid profile, and medication requirements were tested. Additionally, patients were grouped or staged based upon therapy required for control of diabetes at the beginning of weight loss intervention. Analysis of covariance described relationships between diabetes disease stage and weight loss at 12 months.
  
  
  RESULTS
  Nondiabetic patients had greater mean reduction in BMI than the diabetic group (7.98 kg/m2 vs. 4.77 kg/m2, p<0.01). A significant linear trend (p<0.001) for decreasing weight loss with stage of diabetes was observed. Blood pressure, lipid profile, and glycemia improved significantly. The average daily glyburide-equivalent dose decreased from 9.4 to 3.0 mg (p<0.01).
  
  
  CONCLUSIONS
  Patients with diabetes lost less weight than similarly obese patients without diabetes. Regardless of differential weight loss between groups, cardiovascular disease risk factors improved. Hypoglycemic medication requirements decreased with weight loss therapy. A predictive relationship may exist between diabetes disease stage before weight loss therapy and future weight loss potential.
authors.affiliation: Hennepin County Medical Center, Division of Endocrinology, Minneapolis, MN 55415, USA. mehmoodkhan@sprintmail.com
authors.forename: M A
authors.initials: MA
authors.lastname: Khan
authors.forename: J V
authors.initials: JV
authors.lastname: St Peter
authors.forename: G A
authors.initials: GA
authors.lastname: Breen
authors.forename: G G
authors.initials: GG
authors.lastname: Hartley
authors.forename: J T
authors.initials: JT
authors.lastname: Vessey
mesh_terms: D000328:Adult; D001067:Appetite Depressants / Q000627:therapeutic use*; D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D004038:Diet, Reducing; D015444:Exercise; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001067:Appetite Depressants; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008055:Lipids