In contrast, the 52% of patients who did not maintain their initial loss had a lower initial loss that averaged 20 pounds after 12 weeks and then quickly rebounded to an average net loss of about 6 pounds by 1 year after the intervention began. The patients in this group then stayed at an average loss of about 3-8 pounds through the remaining 3 years of follow-up.
The entire group of program participants averaged a sharp, roughly 1-percentage-point drop in their hemoglobin A1c level, from a starting level of about 7.4% to about 6.4% by the end of the initial 12-week intervention. The levels then rebounded just as sharply in both subgroups. However, by the end of 4 years, patients in the subgroup that maintained weight loss had an average HbA1c of 6.9%, significantly below the average 8.0% level in patients who regained much of their weight.
Ms. Arathuzik speculated that many patients had a sharp drop and then a rebound in their HbA1c levels because of the "huge" reduction in drug treatment many patients had when their weight initially dropped. The reduced need for medications initially cut annual costs by an average of more than $500 per patient. But their need for treatment increased once their weight rose again.
The patients who successfully maintained their weight loss also showed an average decline in their blood pressure of about 4/2 mm Hg at 4 years compared with baseline. Patients in both groups had an average drop in their low density lipoprotein (LDL) cholesterol of 6-9 mg/dL after 4 years, and an average increase in their high density lipoprotein (HDL) cholesterol of about 7 mg/dL, compared with baseline after 4 years.
Future research will examine ways to maintain patients in diabetes remission through weight loss, she said. Another area for further research is to find factors that identify patients who will maintain their weight loss. "We have been bad at predicting who will maintain their loss and who will regain weight," Ms. Arathuzik said in an interview.
Ms. Arathuzik and Ms. Kirpitch said that they had no disclosures.
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