INFLUENCES ON WEIGHT-LOSS IN TYPE-2 DIABETIC-PATIENTS - LITTLE LONG-TERM BENEFIT FROM GROUP-BEHAVIOR THERAPY AND EXERCISE TRAINING

The aim of our study was to assess the long-term (24 months) efficacy of a comprehensive weight reduction programme as compared to that of a conventional programme. The Comprehensive Programme comprised, beside s the Conventional Programme (diet counselling), behavioural modificat ion and exercise training. The 2-year follow-up period was completed b y 53 patients (19M/34F; 88.3 %). The differences (95 % confidence inte rvals; CI) between the change in body weight of patients in the Compre hensive Programme compared to the Conventional Programme after 6 and 2 4 months of treatment were -2.2 (-4.0, -0.3) kg, p = 0.03 and -1.3 (-3 .3, 0.7) kg, p = 0.21, respectively. In comparison to the Conventional Programme, the Comprehensive Programme resulted in a greater decrease (95 % CI) of HbA1c after 6 months: -0.8 (-1.2, -0.2) %, p = 0.01, but not after 2 years: -0.4 (-1.0, 0.1) %, p = 0.12. The effects on blood pressure and serum lipids of the Comprehensive Programme and the Conv entional Programme were comparable. Changes in body weight at 6 months correlated well with changes in HbA1c, fasting plasma insulin, and bl ood pressure, whereas at 24 months no.such correlation was found with HbA1c. Pretreatment variates that were associated with the greatest 2- year weight loss were a high HbA1c value, a low energy per cent carboh ydrate intake and a low percentage of obese subjects within the family . In conclusion, the long-term outcome of the Comprehensive Programme was not different from that of the Conventional Programme. The achieve d body weight reduction was associated with a sustained fall in blood pressure, but with only a transient beneficial effect on the glycaemic control in the Type 2 diabetic patient.