A clinical score to predict dose reductions of?antidiabetes medications with intentional weight loss: A retrospective cohort study

摘要

Background We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss. Methods Case records of 121 overweight and obese patients with {DM} at two outpatient weight management centers were analyzed. Results Mean period of follow-up was 12.5?±?3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 [marker of insulin resistance] at baseline), and “G” (glycosylated hemoglobin [A1c%] >8.5 at baseline). {WIG} score showed moderate accuracy in discriminating anti-DM dose reductions at baseline, and after 3 months of weight loss efforts (likelihood ratios [LR] + >1, LR? 0.7), and demonstrated good reproducibility. Conclusions {WIG} score shows promise as a tool to predict success with dose reductions of antidiabetes medications.