Specific recommendations for weight-loss interventions for individuals with type 2 diabetes and OW/OB are summarized in Table 3.3. But it is recognized that for individuals who are OW/OB, achieving and maintaining an optimal body mass can be an uphill battle even in the absence of type 2 diabetes complications. While some patients are successful in maintaining at least some of their weight-loss achievement in the long term (54), dietary recidivism seems to be the rule rather than the exception. Thus, while many different dietary schemes show good success in the short term, most OB patients are unable to fully maintain their lower body weights in the long term.
As an additional challenge, OB patients who have type 2 diabetes may be more resistant to the maintenance of weight loss because antidiabetic drugs, such as insulin and sulfonylurea, often promote weight gain. The progressive nature of diabetes means that even with successful monotherapy (e.g., management by diet/weight loss) glycemic control may deteriorate over time, necessitating the addition of
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