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Guidelines on Overweight and Obesity: Electronic Textbook ![]() |
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Impaired Glucose Tolerance and Diabetes Forty-nine articles on RCTs were reviewed to evaluate the effect of weight loss on fasting blood glucose and fasting insulin (70, 362, 367, 369, 373, 386, 387, 390-393, 403, 404, 408, 412-415, 439, 440, 446, 470, 473, 474, 482, 485, 490, 492, 493, 576, 676-678, 681, 683, 684, 689, 690, 693, 694, 696-698, 700-702, 708, 709, 712). Studies were conducted in
individuals with normal blood glucose levels (fasting plasma glucose <115
mg/dL [ <6.4 mmol/L]) (367, 373, 386, 387,
390-393, 403, 412, 415, 677, 678, 681, 683, 684, 689, 690, 694, 696-698,
700) in individuals with impaired glucose tolerance (fasting plasma glucose
of <140 mg/dL [7.8 mmol/L] or 2 hours postprandial plasma glucose of >140
to <200 mg/dL [7.8 to 11.1 mmol/L]) (70,
369), or in individuals with diabetes (fasting plasma glucose of >140
mg/dL or 2 hours postprandial plasma blood glucose Of the 38 trials reviewed on the role of lifestyle in weight loss and subsequent changes in blood glucose levels, 16 were on diet alone (70, 373, 412, 413, 415, 439, 440, 576, 677, 683, 689, 693, 701, 702, 708, 709), 8 dealt with physical activity alone (70, 369, 404. 474, 676, 678, 690, 700), 8 focused on diet plus physical activity (70, 362, 403, 446, 470, 473, 681, 684), and 5 examined the role of behavior therapy (367, 482, 485, 490, 493). One study included diet, behavior therapy, and physical activity (694). One study (414) included diet, behavioral therapy, and drug therapy. Of the 38 trials, 9 were accepted, and 29 were not considered for these reasons:
*The reviewed articles used
the "old" definitions of the American Diabetes Association (ADA) for
impaired glucose tolerance and diabetes. As of November 1997, the new ADA
definitions define "impaired fasting glucose" as those individuals
having a fasting plasma glucose of 110 to 125 mg/dL, and "diabetes"
as those individuals having a fasting plasma glucose of Of the 12 pharmacotherapy trials reviewed, 8 were accepted and 4 were excluded for these reasons:
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