Losing weight lowers health care costs for adults with type 2 diabetes

Overweight individuals with diabetes who lose weight by dieting and increasing their physical activity can reduce their health care costs by an average of more than $500 per year, according to a new study.

“Lifestyle interventions promoting weight loss and physical activity are recommended for overweight and obese people with Type 2 diabetes to improve their health,” said Mark A. Espeland, professor of public health sciences at Wake Forest Baptist Medical Center and lead author of the study. “This is the first study to show that weight loss can also save money for these individuals by reducing their health care needs and costs.”

The research is published in the Aug. 21 online issue of the journal Diabetes Care.

The study evaluated 5,121 obese and overweight people between the ages of 45 and 76 with Type 2 diabetes who participated in the National Institute of Health-sponsored Action for Health in Diabetes (Look AHEAD) study beginning in 2001. Half of the participants at each of the study’s 16 sites across the country were randomly assigned to intensive lifestyle intervention (ILI) or diabetes support and education (DSE) programs, and their medical histories were tracked through 2012.

Those in the ILI group had 11 percent fewer hospitalizations and 15 percent shorter hospital stays. They also used fewer prescription medications. Both of these benefits of ILI contributed to an average saving of $5,280 per person in health care costs over 10 years (or $528 per year).

Espeland said the people in the ILI program maintained lower weights and higher levels of physical activity throughout the study than those in the DSE group, resulting in better control of their diabetes, blood pressure, sleep quality, physical function and symptoms of depression. He added that the cost savings for those in the ILI group were relatively consistent regardless of age, initial weight, gender or ethnicity.

Diabetes and Weight Loss
Maintaining a healthy weight can seem a never-ending challenge

Type 2 diabetes is very closely associated with weight, with over 90% of newly diagnosed type 2 diabetics above their ideal weight.

Being overweight can hurt your confidence, and getting back to a healthy weight can seem like a never-ending challenge.

However, losing some weight could both prevent you from developing diabetes, or help you to better manage your disease if you have already been diagnosed with diabetes.

First things first
First off, work out how overweight you actually are.

Most people will have an intuitive sense of what a healthy weight is for them, but understanding how much you have to lose can make all the difference in having clear goals.

Talking about weight loss can be tough, particularly if you do not know your doctor or diabetes specialist very well, but understanding weight loss can make all the difference.

Type 2 diabetes is a chronic disease that is affecting more and more adults, increasing their health care needs and costs,” Espeland said. “This study shows that by losing weight and being physically active, individuals can reduce these costs.”


What Are the Benefits of Weight Loss?

Losing weight when you have type 2 diabetes can improve your health and help you feel better overall. The American Diabetes Association® says that losing weight can help1:

  • Lower blood sugar
  • Reduce blood pressure
  • Improve cholesterol levels
  • Lighten the stress on hips, knees, ankles, and feet

Tips for Achieving Weight Loss

  • Set realistic goals. Gradual change is more likely to lead to permanent change. Break big goals into smaller goals. For example, try to walk one mile in 15 minutes 3 times a day instead of walking three miles in 45 minutes.

  • Keep a food record. Write down what and how much you plan on eating before you eat it. This will help you be more aware of your food intake. And don’t forget to write down those calorie-containing drinks!

  • Keep temptation foods out of the house. When you’ve got a serious craving, buy it — but only one portion of it. Eat and enjoy it, but then forget it. If you buy a larger amount, you’ll be more likely to eat it until it’s all gone.

  • Exercise regularly. Studies have shown that people with diabetes who exercise regularly have better A1C levels than those who don’t. Start out slow and work your way up to a regimen that’s best for you. Be sure to check your blood sugar before and after exercise, drink plenty of water, and carry a snack to treat low blood sugar. And of course, make sure you check with your health care provider before you begin any exercise routine.

  • Measure all food and drink for at least two weeks. Use the same size plates, cups, bowls, and glasses to help control portions. Re-measure once or twice a month to prevent portion sizes from creeping back up. Once you know serving sizes, you can start to eyeball your portions.

  • Stick with the measuring tape. When it comes to shedding body fat, the scale isn’t always your friend. Keep in mind that the best way to slim down is to change your eating habits while increasing physical activity. Exercising, however, builds muscle mass — and that’s a good thing. The more muscle you have, the more calories your body burns at rest. But because muscle weighs more than fat, seriously increasing your muscle mass will cause your weight to go up. So don’t be fooled by the number on the scale. Relying on a measuring tape will let you keep an eye on the inches you lose around your waist, hips, thighs, and upper arms.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health with additional support from the National Heart, Blood and Lung Institute of the NIH and the Centers for Disease Control and Prevention.

Co-authors of the study are Alain Bertoni, M.D., Julia Rushing, M.S., and Don G. Hire, B.S., Wake Forest Baptist; Henry A. Glick, Ph.D., and Thomas A. Wadden, Ph.D., University of Pennsylvania; Frederick L. Brancati, M.D., and Jeanne M. Clark, M.D., Johns Hopkins School of Medicine; George A. Bray, M.D., and Donna H. Ryan, M.D., Pennington Biomedical Research Center; Jeffrey M. Curtis, M.D., William C. Knowler, M.D., Ph.D., and Tina Killean, Phoenix Indian Medical Center; Rena R. Wing, Ph.D., and Caitlin Egan, M.S., Brown Medical School/The Miriam Hospital; Mary Evans, Ph.D., Van S. Hubbard, M.D., Ph.D., and Susan Z. Yanovski, M.D., National Institute of Diabetes and Digestive and Kidney Diseases; John P. Foreyt, Ph.D., and Henry Pownall, Ph.D., Baylor College of Medicine; Siran Ghazarian, M.D., and Anne L. Peters, M.D., Roybal Comprehensive Health Center; Edward W. Gregg, Ph.D., and Ping Zhang, Ph.D., Centers for Disease Control and Prevention; Helen P. Hazuda, Ph.D., and Maria G. Montez, M.S., University of Texas Health Sciences Center at San Antonio; James O. Hill, Ph.D., Adam G. Tsai, M.D., and Marsha Miller, University of Colorado Health Sciences Center at Aurora; Edward S. Horton, M.D., Joslin Diabetes Center; John M. Jakicic, Ph.D., and Andrea Kriska, Ph.D., University of Pittsburgh; Robert W. Jeffery, Ph.D., and J. Bruce Redmon, M.D., University of Minnesota; Karen C. Johnson, M.D., Abbas E. Kitabchi, M.D., and Ebenezer A. Nyenwe, M.D., University of Tennessee Health Sciences Center at Memphis; Steven E. Kahn, M.B., and Anne Murillo, B.S., University of Washington; Cora E. Lewis, M.D., and Monika Safford, M.D., University of Alabama at Birmingham; David M. Nathan, M.D., Massachusetts General Hospital; and Xavier P. Sunyer, M.D., and Jennifer Patricio, M.S., St. Luke’s-Roosevelt Hospital.


Marguerite Beck

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Wake Forest Baptist Medical Center

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