How does weight loss affect cardiovascular disease risk and hepatic steatosis in type 2 diabetes mellitus (DM)?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Modest weight losses of 5-10% have been associated with significant improvements in cardiovascular disease risk factors (ie, decreased HbA1c levels, reduced blood pressure, increase in HDL cholesterol, decreased plasma triglycerides) in patients with type 2 diabetes mellitus. Risk factor reduction was even greater with losses of 10-15% of body weight. [252, 253]

A study by Lazo et al attested to the benefits of lifestyle intervention, which aimed at a minimum weight loss of 7%, on hepatic steatosis in patients with type 2 diabetes. [254] Since there is no known treatment for nonalcoholic fatty liver disease, a weight loss strategy may help to prevent progression to serious liver damage.

One-year results from the open-label, randomized Diabetes Remission Clinical Trial (DiRECT) demonstrated a type 2 diabetes remission rate of 46% in participants who underwent intervention with a very low–calorie liquid diet. The regimen included gradual reintroduction of food after 3-5 months and ongoing weight-loss maintenance support. The remission rate reached 73% in just those patients in the intervention group who at 12 months had maintained a weight loss of at least 10 kg. [255, 256]


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