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Prevention of Weight Gain in Adult Patients With Type 2 Diabetes Treated With Pioglitazone
Author(s) -
Kushner Robert F.,
Sujak Melissa
Publication year - 2009
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1038/oby.2008.651
Subject(s) - pioglitazone , medicine , overweight , weight gain , type 2 diabetes , weight loss , randomized controlled trial , obesity , diabetes mellitus , thiazolidinedione , adipose tissue , weight change , endocrinology , body weight
Pioglitazone, a thiazolidinedione (TZD) commonly used to treat type 2 diabetes, is associated with weight gain. Our study was designed to examine the effectiveness of three lifestyle‐treatment programs of varying intensity on prevention of pioglitazone‐induced weight gain and to measure the composition of the change in body weight. Thirty‐nine adult overweight and obese subjects with type 2 diabetes mellitus were all treated with pioglitazone and prospectively randomized to one of three lifestyle‐treatment programs with increasing level of intensity for 24 weeks. Body composition was measured by dual‐energy X‐ray absorptiometry (DXA), computed tomography, and multifrequency bioimpedance analysis both before and after therapy. Subjects demonstrated a “dose‐response” effectiveness to three levels of lifestyle intervention to mitigate pioglitazone‐induced weight gain. Mean (s.d.) weight change (kg) for the usual, standard, and intensive lifestyle groups were 4.9 ± 4.9 ( P = 0.005), 1.8 ± 3.4 ( P = 0.02), and −0.2 ± 4.4 (NS) respectively. Total body fat increased 2.6 ± 3.4 kg ( P = 0.04) for the usual group and decreased for the intensive group −0.4 ± 3.5 (NS). Change in abdominal subcutaneous and visceral adipose tissue (VAT) did not differ between groups, although ratio of visceral/subcutaneous fat decreased for the standard and intensive groups (NS). Both usual ( P < 0.05) and standard care (NS) groups gained total body water. This is the first prospective, randomized study that demonstrates the beneficial effect of participation in a comprehensive lifestyle‐weight‐management program on lessening of weight gain associated with pioglitazone.