RESEARCH: Metformin and Carbohydrate-Modified Diet May Help Sustain Weight Loss

nobimbo · 12-17-2003, 11:17 PM

Metformin and Carbohydrate-Modified Diet May Help Sustain Weight Loss
A DGReview of :"Long-term (2-4 year) weight reduction with metformin plus carbohydrate-modified diet in euglycemic, hyperinsulinemic, midlife women (syndrome w)"
Heart Disease

12/16/2003
By Jill Taylor

The combined regimen of metformin and a carbohydrate-modified diet promotes long-term weight stabilisation in obese, middle-aged, nondiabetic women with documented insulin abnormalities, say American researchers.

The majority of patients who successfully lose weight in traditional dietary programs regain the weight within 2 to 4 years, and few treatment strategies for sustained weight reduction exist that are effective, safe, and acceptable.

In a previous study, women with Syndrome W, an early variant of the Metabolic Syndrome, achieved significant weight loss with metformin and a carbohydreate-modified, hypocaloric, low-glycaemic-index diet.

To assess the long-term efficacy this regimen, Harriette R Mogul, MD, MPH, and colleagues of New York Medical College, Valhalla, United States, conducted a retrospective analysis of 21 study participants who returned for medication renewal and annual surveillance visits.

All patients included in the analysis had achieved a 1-year weight loss of more than 10% or body mass index (BMI) normalisation. Baseline characteristics included an average age of 55.2 years, BMI of 34.2 kg/m2, and weight of 196.9 lbs.

The researchers observed weight maintenance at the final (2 to 4 years) follow-up visit in 90.5% of the women, with the mean weight at final follow-up highly correlated with mean weight at 1-year protocol completion.

Furthermore, a significant and robust decline in fasting insulin (-27.5% -43.8%, P < .002) was observed at all follow-up visits. Metformin was well tolerated, without reported side effects or electrolyte imbalance.

Although researchers acknowledge clear methodologic limitation, they hope that the study findings will encourage clinicians to contemplate the potential viability of defining and treating insulin abnormalities in euglycemic women with midlife weight gain who fail to respond to other obesity interventions.

"We believe this effective novel obesity treatment, which is easily implemented in a clinical setting, could have important implications for women with Syndrome W, and quite possibly for other subpopulations of obese nondiabetic Americans with progressive weight gain and documented hyperinsulinemia," they conclude.

http://www.docguide.com/news/conten...0Other&count=10

Linda

KYBluegrass · 12-18-2003, 11:45 AM

We can always count on you to be a wealth of information!

You are really doing your homework! I did see this study, and I gotta say, yep I agree!!! After nearly two years on met, my BMI went from "don't you DARE ask" to 23. For the first time in my life, I am able to eat and exercise normally without killing myself, and maintain my weight. Thanks for this info!

christyz · 12-18-2003, 12:36 PM

Thanks for the info, Linda. I'm adding this study to the relevant place in the FAQ thread. I'm happy to see a study that encourages both the aspects of meds and diet. Met without the diet is an attempt at a shortcut, and there really are none with metformin.

This study is ME all over the place! I hope these studies will make Met more readily accessible to PCOS women because for women like Tracey, me, and countless others, IT WORKS. In terms of my own personal life, It's the best gift I could ever have been given...long term health.

ImCysted · 04-26-2004, 02:52 PM

I'm from Red Lodge Montana! Enjoy yourself!

Mikema · 03-13-2006, 09:35 AM

I am very new (first post). I was diagnosed with PCOS last week and we are doing a 6 month stint on Met and if we want to get pregnant, clomid. However, I am holding off on the clomid because I want to see if I can learn a new way of eating for my condition of Insulin Resistance, and I already exercise 4 days out of the week but it is not helping because I am not eating properly. I have a 2.5 year old daughter who is very active and a husband who loves sports. PLEASE direct me to a link that has diet suggestions or e-mail them to me. After I get more familiar with the site, I will be happy to post progress.

God bless you all!

PS: Any help you list will be greatly appreciated.

christyz · 03-13-2006, 04:59 PM

Here is a link on the IR diet in a nutshell:
IR Diet In A Nutshell

I have done a ton of reading on this and studies are showing that women with PCOS have insulin resistance to differing degrees, even women whose fasting glucose tests are in 'normal' ranges (mine were always borderline). So since insulin and male hormones are very inter-connected, I took the approach that the key for controlling PCOS with diet is by eating to keep my insulin as stable as possible.

What worked for me:
~ Focus on specific kinds of carbs:
a) Whole grains: These have lots of fiber. Dietary fiber, among its benefits to the digestive process, reduces the amount of dietary cholesterol that is absorbed into the bloodstream. By slowing absorption of nutrients, fiber also reduces the glycemic load of foods eaten with fiber-rich foods. Plus the less refined foods are, the more nutritious they are AND the less your blood sugar will be affected. This means less hunger later on..
b) Fruits and Veggies: Again, high in fiber, anti-oxidents (that repair cell damage) and things like cherries and berries are low glycemic, so your insulin rises slower when you eat those.
c) Milk and Milk products: Milk has carbs in it, but they are not glucose based but LACTOSE based, so they don't affect insulin as much. Plus it's high in protien and turns semi-solid in the stomach so you feel fuller longer.
~Eating whole food as often as possible and decrease highly processed or high sugar foods as much as you can.
~Eat small meals more often. This keeps your blood sugar more regular and avoids the insulin spikes that cause huge cravings. Eating small meals more often also speeds up your metabolic rate, allowing your body to absorb and use more nutrients and increase energy levels. It will also decrease fat storage by controlling your portion size and never giving your body more calories than it can utilize in one sitting.
~ Drink lots of water. If the kidneys are water-deprived, the liver has to do their work along with its own, lowering its total productivity. It then can’t metabolize fat as quickly or efficiently as it could if you were better hydrated. Dehydration not only is unfair to your liver, it sets you up to store fat. The overweight person also needs more water than a thin one due to larger metabolic loads.
~ Eat lots of lean protein: Protein doesn't spike blood sugar and takes longer for your body to digest, burning more calories. It is really beneficial to eat some protein when you eat carbs. It reduces the glycemic load of the carbs, just like fiber.
~ Eat lots of healthy fats (monounsaturated and polyunsaturated) like olive oil and fish oils. They help our hearts and help our bodies repair our insulin receptors. Unsaturated fats also play a role in proper hormone productions, so we need them!
~ I ate very little soy. It's an often-used product in many low carb products, but I have done a lot of reading on soy and it has some properties that I'm a little leery about. This isn't everybody's choice, but I lost my weight with very little soy because of my concerns over it's effects on thyroid and it's antithyroid properties. It's also mildly estrogenic. So as somebody with hormone issues since my teen years (who finally has them back in control again), I don't want to throw any new hormone into the mix.
~ Regular, deliberate cardiovascular exercise. It improves our sensitivity to insulin if done consistently.
~ Don't try to overhaul your life in 1 day. Too many sweeping changes will just overwhelm you and make you feel deprived. Set a goal for each day or each week and start out slowly. Small steps still get you a million miles.
~And make changes that you can actually LIVE with long term. For me, I cut saturated fats in my diet, but there were some things I knew I'd never be able to do forever (like skim milk or fat free yogurts...blech). Do your homework and look for alternative sweeteners or have real sugar in moderation like I did. Make changes you can actually live with long term or you'll fail before you start.

Hope it helps!

yoneeley · 03-13-2006, 09:33 PM

Linda & Christyz-
Thanks for all the great info you give! It motivates me. I seem to get easily discouraged and it always helps to see your success and remember that it didn't happen overnight.
To everyone else-Good luck!
Hope everyone has great results!

KatCarney · 11-11-2006, 11:23 PM

Great article