Metabolic Score Helps Target Appropriate Weight Loss Therapy for Diabetes Prevention

Cardiometabolic disease staging (CMDS) can help target the effectiveness of weight loss therapy in preventing type 2 diabetes among overweight or obese patients, according to a recent study.

In their study, the researchers evaluated 3040 overweight and obese participants using data obtained from 3 trials: CONQUER, EQUIP and SEQUEL. These 3 trials assessed the safety and efficacy of phentermine/topiramate extended release for weight loss.
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In each trial, participants underwent a lifestyle intervention and were randomly assigned to receive either once-daily oral phentermine/topiramate extended release or placebo. The researchers calculated weighted CMDS scores based on baseline waist circumference, blood glucose, blood pressure, and blood lipids.

The researchers defined incident diabetes based on serial measures of fasting glucose, 2-h oral glucose tolerance test glucose, and/or HbA_1c.

Results indicated that participants with high-risk CMDS scores at baseline demonstrated the greatest absolute decrease in 1-year diabetes incidence rates. Participants with moderate-risk scores showed a moderate decrease in 1-year incidence rates, and those with low-risk scores showed a small decrease.

The researchers noted that the number of participants needed to treat to prevent 1 new case of diabetes over a 56-week period was 24 participants with CMDS scores of 60 or higher at baseline, 43 participants with scores between 30 and 59, and 120 participants with scores between 0 and 29.

“Numbers needed to treat to prevent one case of type 2 diabetes are markedly lower in patients with high-risk scores,” the researchers concluded. “CMDS can be used to quantify risk of diabetes in overweight/obese individuals and predict the effectiveness of weight-loss therapy to prevent diabetes.”

—Christina Vogt

Reference:

Gao F, Garvey WT. Cardiometabolic disease staging predicts effectiveness of weight-loss therapy to prevent type 2 diabetes: pooled results from phase III clinical trials assessing phentermine/topiramate extended release. Diabetes Care. 2017;40(7):856-862. doi:10.2337/dc17-0088.