title: Association between glycosylated hemoglobin and intentional weight loss in overweight and obese patients with type 2 diabetes mellitus: a retrospective cohort study.
abstract: The purpose of this study is to assess the relationship between magnitude of weight loss and improvement in percentage A1C (A1C%) among overweight and obese patients with type 2 diabetes mellitus (DM) undergoing weight reduction.
  
  
  
  Case records of patients enrolled in 2 university-based weight management programs were reviewed. Patients were sampled if they had a diagnosis of DM and had at least 1 documented A1C% reduction from their baseline value. Weight loss treatment was individualized and consisted of a calorie-restricted diet, a behavior modification plan, and a plan for increasing physical activity. Patient weights were measured at bimonthly visits. A1C% was measured every 3 months.
  
  
  
  Seventy-two patients formed the study cohort. Mean baseline body mass index was 35.1 kg/m(2), mean age was 52.6 years, and 59% were males. Mean starting A1C% was 8.6. Patients achieved significant mean weight loss (10.7 kg) at study exit. Weight loss of 6.5 kg (4.5% of baseline body weight), 12.2 kg (8.7%), and 15.9 kg (10.3%) was required to reduce A1C% by 0.5, 1, and 1.5, respectively, and it took a mean of 5.6, 8.7, and 10.1 months, respectively, to achieve this. After adjustment for antidiabetic medication intake, for every 10% weight loss, the predicted reduction in A1C% was 0.81.
  
  
  
  Intentional weight loss of 10% can potentially decrease A1C% by 0.81 among patients with type 2 DM. This finding may be clinically useful in encouraging and counseling a patient attempting weight loss.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Shantha, Dr Kumar)
authors.forename: Ghanshyam Palamaner Subash
authors.initials: GP
authors.lastname: Shantha
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Shantha, Dr Kumar)
authors.forename: Anita Ashok
authors.initials: AA
authors.lastname: Kumar
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and George Washington University School of Public Health and Health Services, Washington, DC (Dr Kahan)
authors.forename: Scott
authors.initials: S
authors.lastname: Kahan
authors.affiliation: Johns Hopkins Weight Management Center, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, (Dr Cheskin)
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cheskin
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000628:therapy; D050177:Overweight / Q000097:blood* / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human