Weight Loss Impact on Diabetes to Be Studied

11-year project will involve 5,000 volunteers from across the U.S.

SUNDAY, July 29, 2001 (HealthDayNews) -- What's the most effective way for people with Type II diabetes to lose weight, and how does that weight loss help them?

Those are the questions researchers hope to answer at the end of an ambitious, 11-year study that will examine the effects of weight loss on people with Type II, or adult-onset, diabetes.

With a budget of $180 million, the study, to be known as Look AHEAD (Action for Health in Diabetes), is the largest project of its kind ever funded by the National Institutes of Health.

Participants will include 5,000 volunteers recruited by 16 centers around the country.

About 90 percent of all people who are newly diagnosed Type II diabetics are overweight. Obesity increases "insulin resistance and contributes to many health problems, including heart and blood vessel disease," according to the American Diabetes Association.

"And when obese people with Type II diabetes lose weight, they often experience a lowering of their blood glucose levels and are then able to decrease their insulin or oral diabetes medications," the ADA adds.

Mark A. Espeland, a professor of public health sciences at Wake Forest University School of Medicine, says the study's participants will be randomly divided into two control groups -- one receiving close weight-loss instruction and monitoring, and the other attending only occasional educational sessions.

"One group will be attending weekly sessions in which they'll talk about diet and exercise, and, if appropriate, they'll be put on liquid meal supplements or portion-control diets. Counselors will work closely with them to see what can be done about weight loss," Espeland says.

"The second group will attend just three or four sessions a year that will provide some background on diabetes management, including advice about how important it is to lose weight if you're overweight," he adds. "They will also be given information about managing the symptoms of Type II diabetes, but we're actually not expecting too much weight loss in that group overall."

Wake Forest University will be the national coordinating center for the study but is not one of the participating volunteer centers.

Espeland says the length of the study is necessary in order to assess long-term effects of managing the disease.

"The reason we need such a long period of time is that problems related to diabetes, such as heart attacks and stroke, accrue fairly slowly. We need to have enough information on these outcomes, and it takes time to get that information," he says.

Study participants will be people between the ages of 45 and 75 who have Type II diabetes and who are overweight, which will be determined using a formula known as the body mass index (BMI).

People with a BMI over 25 qualify for the study. So, for example, a 5-foot-4-inch woman who weighs 150 pounds would qualify, as would a 6-foot man who weighs 190 pounds. The goal for the participants will be to lose 10 percent of their initial weight and then keep it off.

Dr. Xavier Pi-Sunyer, chief of the endocrinology division at St. Luke's Roosevelt Hospital in New York City, says losing weight can be even more of a challenge for people with diabetes than for those who don't have the disease.

"For reasons that are unknown, people with diabetes tend to have a more difficult time losing weight and keeping it off, so that's a problem," he says.

The incentive for losing weight is that doing so improves the symptoms of diabetes, Pi-Sunyer says.

"For most people it doesn't reverse with weight loss, but the diabetes does gets better. The blood sugars get lower and it's not as serious," he says.

What To Do: Visit the American Diabetes Association for information on healthy living for diabetics. And you can look up your own body mass index at the Body Fat Lab.

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