Impact of Weight Change in Adults with Type 2 Diabetes Mellitus: A Literature Review and Critical Analysis
Received 9 June 2020
Accepted for publication 9 September 2020
Published 29 September 2020 Volume 2020:12 Pages 555—566
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Giorgio Lorenzo Colombo
Moshe Fridman,1 Mariann E Lucas,2 Yurek Paprocki,3 Tam Dang-Tan,4 Neeraj N Iyer5
1Biostatistics, AMF Consulting, Los Angeles, CA, USA; 2Information Science, Scientific Analytics, Novo Nordisk Inc, Plainsboro Township, NJ, USA; 3Medical Affairs, Novo Nordisk Inc, Plainsboro Township, NJ, USA; 4Medical Affairs, Novo Nordisk Inc, Plainsboro Township, NJ, USA; 5HEOR Strategy & Evidence Generation - Diabetes, Novo Nordisk Inc, Plainsboro Township, NJ, USA
Correspondence: Neeraj N Iyer
Novo Nordisk, Inc, 800 Scudders Mill Road, PlainsboroTownship, NJ 08536, USA
Tel +1 609 578 8157
Objective: Weight reduction is a key component of diabetes management in adults with type 2 diabetes mellitus (T2DM), yet the benefits of weight loss in T2DM patients have been difficult to quantify. We examined the medical literature regarding the relationships between weight change and 1) glycemic control and 2) cost and resource use.
Methods: Systematic searches were conducted in the electronic databases Embase, MEDLINE, and the Cochrane Database of Systematic Reviews to identify publications regarding the impact of weight change on T2DM outcomes from 2007 onward. Identified publications were screened for relevance against predefined eligibility criteria, and methodological approaches and results were extracted. Evidence for the impact of weight change on outcomes was evaluated and used to identify strengths, limitations, and gaps in the current literature.
Results: The number of studies meeting eligibility criteria for each outcome was: glycemic control (n=38) and cost and resource use (n=11). The relationship between weight change and glycemic control was dependent on the interplay of multiple factors, eg, the weight loss interventions employed, the antidiabetic medication classes used, the time horizon, and baseline BMI and glycemic control. With respect to cost and resource use, the review indicated that savings were associated with weight loss, and increased costs were associated with weight gain.
Conclusion: Studies regarding weight change in T2DM patients demonstrated varying effects on glycemic control and a positive association with costs and resource use, where weight loss was associated with decreased costs and resource use. Future studies may be able to clarify these relationships.
Keywords: type 2 diabetes, overweight/therapy, obesity/therapy, weight loss, cost, resource utilization, economics
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