Body weight, diabetes incidence vascular events and survival 15 years after very low calorie diet in community medical clinics in the UK.
Authors
Daniels, Charles
Howitt, Will
Greatorex, Derek
Campbell, Claire
Paisey, Christopher
Paisey, Rosamund
Frost, Julie
Bromige, Robert
Publication Date
2022Journal Title
BMJ Nutr Prev Health
ISSN
2516-5542
Publisher
BMJ
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Paisey, R., Daniels, C., Howitt, W., Greatorex, D., Campbell, C., Paisey, C., Paisey, R., et al. (2022). Body weight, diabetes incidence vascular events and survival 15 years after very low calorie diet in community medical clinics in the UK.. BMJ Nutr Prev Health https://doi.org/10.1136/bmjnph-2021-000363
Abstract
Objective: To assess weight loss maintenance, diabetes status, mortality and morbidity 15 years after a very low calorie diet programme (VLCD) in patients with obesity. Design: General practice data bases were interrogated for subjects coded for group therapy with VLCD in the 1990s. Causes of death, occurrence of vascular disease and remission or development of diabetes were ascertained from patient records and national stroke and cardiovascular disease data bases. Results: 325 subjects engaged in the programme and had sufficient data for analysis. Baseline characteristics were: age 47.8±12. 8 years; body mass index (BMI) 36.1±6.8 kg/m2; 79.1% female/20.9% male; 13.5% had type 2 diabetes. After 15±4 years weight had changed from 97.9±19 kg at baseline to 100±20.8 kg. 10 with diabetes at baseline were in remission at 3 months, but only two remained in remission at 5 years. 50 new cases of type 2 diabetes and 11 of impaired fasting glucose developed during follow-up. Only 5.9% who remained healthy at follow-up had maintained >10% body weight reduction. Neither diabetes incidence nor diabetes free survival were related to percentage body weight lost during VLCD. Only baseline BMI was related to development of new impaired fasting glucose or diabetes by 15 years (p=0.007). 37 subjects had a cardiovascular event. Age (p=0.000002) and degree of weight loss after VLCD (p=0.03) were significantly associated with subsequent vascular events. Conclusion: Long-term maintenance of weight loss after VLCD was rare in this single centre retrospective study 15 years later. Glucose intolerance developed in 21.4%. Lasting remission of type 2 diabetes or prevention of later glucose intolerance were not achieved. Vascular events were more frequent in those who lost most weight. Risk management during weight regain should be studied in future to assess potential for reduction in adverse cardiovascular outcomes.
Keywords
Original research, 1506, diabetes mellitus, weight management, nutritional treatment
Sponsorship
Torbay Special medical projects (PS/MAO/T/PAIS001)
Identifiers
bmjnph-2021-000363
External DOI: https://doi.org/10.1136/bmjnph-2021-000363
This record's URL: https://www.repository.cam.ac.uk/handle/1810/334804
Rights
Licence:
http://creativecommons.org/licenses/by-nc/4.0/
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