More than 90% of patients with Type 2 diabetes are overweight or are obese (people with Type 1 are sometimes underweight). Weight gain and obesity worsen insulin resistance whereas weight loss slows the progression of diabetes complications.
Weight loss of 5-10% of baseline body weight is recommended as an initial goal of treatment, and this amount of weight loss is associated with a 0,6-1,0% reduction in HbA1c and numerous other health improvements, including reduced sleep apnoea, reduced need for diabetes medications, improved mobility and quality of life, fewer hospitalisations, and reduced healthcare costs.
When ≥10% of body weight is lost and sustained, improvements in cardiovascular morbidity and mortality are also seen.
However, weight loss of as little as 2-5% produces a clinically meaningful reduction in fasting blood glucose.
The American Diabetes Association (ADA) recommends that patients with prediabetes lose 7% of baseline body weight to avoid developing diabetes.
A sustained 7% weight loss improves many other outcomes in patients with diabetes and overweight/obesity, including fitness, decreased waist circumference, reduced blood pressure, improved sexual functioning, and improved reported peripheral neuropathy symptoms.
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