June 26, 2007 — Obese patients with type 2 diabetes mellitus who are assigned to a portion control tool as a treatment of obesity have at least a 5% loss in weight compared with those who receive usual care, according to the results of a 6-month randomized controlled trial published in the June 25 issue of the Archives of Internal Medicine.
"Portion size is an important determinant of energy intake," write Sue D. Pedersen, MD, FRCPC, from the University of Calgary in Alberta, Canada, and colleagues. "To our knowledge, no randomized controlled trial has evaluated the efficacy of portion control tools to induce weight loss. In patients with type 2 diabetes mellitus, weight reduction improves glycemic control."
The investigators randomized 130 obese patients with type 2 diabetes mellitus, including 55 patients taking insulin, to daily use for 6 months of a commercially available portion control plate (intervention group) or to usual care with dietary teaching (usual care control group). Follow-up rate was 93.8%.
Compared with the control group, the intervention group had greater mean weight loss (1.8% ± 3.9% vs 0.1% ± 3.0%; P = .006) and a higher proportion of patients who required a decrease in their diabetes medications at 6 months (26.2% vs 10.8%; P = .04).
"Compared with usual care, the portion control tool studied was effective in inducing weight loss," the authors write. "The portion control plate also enabled patients with diabetes mellitus to decrease their hypoglycemic medications without sacrificing glycemic control."
Post hoc analyses suggested that the significant weight loss using this intervention was primarily seen in patients taking insulin.
Study limitations include poor overall compliance with the intervention, patients who frequently eat meals outside of the home being excluded from the study, lack of double blinding, and lack of data regarding quantitative dietary composition changes or caloric expenditure.
"The portion control tool studied in this trial was effective in inducing weight loss in obese persons with type 2 DM [diabetes mellitus] comparable to that seen in investigations of weight loss pharmacotherapy," the authors conclude. "This simple inexpensive tool also enabled obese patients with DM to decrease their hypoglycemic medication requirements. This intervention holds promise for use in overweight populations with and without DM."
The Stewart Diabetes Education Fund sponsored this study. The Diet Plate donated the portion control tools used in this study. The authors have disclosed no relevant financial relationships.
Arch Intern Med. 2007;167:1277-1283.
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