Weight loss may help cut heart attack, stroke risk in diabetics: Cambridge study

Moderate weight loss may significantly reduce the long-term risk of cardiovascular diseases such as heart attack and stroke in people living with Type 2 diabetes, a Cambridge study has found.

The study, published in the journal Diabetologia, involved 725 white, overweight adult participants from England.

It found that proper weight management combined with routine care may significantly reduce the risk of developing Cardiovascular Diseases (CVD) such as heart attack and strokes.

"In our study, we saw that people who lost at least five per cent weight during the year after Type 2 diabetes diagnosis had a 48 per cent lower hazard of CVD at 10 years compared with people who maintained their weight," Jean Strelitz, a postdoctoral fellow at the University of Cambridge in the UK told PTI.

The participants had their weight measured at the time of their diagnosis and again one year later.

The researchers focussed on weight loss in the year after diabetes was diagnosed, as losing weight early on may be more beneficial than shedding kilos later.

Models were adjusted for age, sex, baseline body-mass index, smoking, occupational socioeconomic status, cardio-protective medication use and treatment group.

Strelitz cautioned that the research does not indicate that lifestyle changes could replace medications taken by diabetics to treat or prevent CVD.

"Our study does not provide any evidence that making lifestyle changes can replace diabetes medication," she said.

"However, our research suggests that people with Type 2 diabetes may benefit from losing weight in the year following diabetes diagnosis to reduce their long-term risk of CVD. Past research has also shown that diabetes can go into remission," Strelitz explained.

The study shows great promise in treating Type 2 diabetes, the 'silent killer' disease that affects many worldwide.

According to a report by International Diabetes Federation, India alone had an estimated 72 million cases reported in 2017, a figure expected to grow up to 134 million by 2045.

"While there may be some contribution from genes and make up of our bodies (more fat, less muscle), changed imbalanced diets and low physical activity (in addition to urban stress and pollution) are main contributors," Anoop Misra, Vice President, Diabetes Foundation (India) told PTI.

Moreover, Type 2 diabetes could also lead to other lifestyle related conditions such as hypertension, heart disease, liver disease etc, he added.

"Future studies should include more diverse study populations so that it would be possible to examine potential differences in the association between weight loss and CVD across different ethnicities or countries," Strelitz said.

She also said that there was no apparent benefit for weight loss to reduce risk of all-cause mortality among people with Type 2 diabetes.

"We did not assess any other health outcomes so we cannot comment on whether weight loss may result in adverse health outcomes for some patients," she added.

Since the participants involved in the study were overweight, the research did not suggest that people with Type 2 diabetes who are normal weight or underweight should also lose weight, said Strelitz.

"Patients should ask their doctor about how they might lose weight in a healthy way, by making healthy lifestyle changes," she said.

Studies have shown evidence that people with Type 2 diabetes could possibly benefit from adopting certain lifestyle changes.

"About 45 minutes of aerobic physical activity and balanced diets -- including correct oils, green leafy vegetables, nuts, low carbs and low saturated fats -- avoidance of cigarettes and alcohol intake and measures to counter stress are recommended," Misra said.

Weight loss or gain is also advised depending upon the patient.
"In underweight people, we usually do not decrease calories (may increase calories) which are required while keeping dietary balances.

"In normal weight people, we give equal-caloric balanced diets. In obese individuals we decrease calories from balanced diets to promote weight loss," said Misra.

Although the Cambridge study links weight loss with reduced CVD risk for Type 2 diabetics, it does not provide any evidence for the same in people with Type 1 diabetes.