A reduction in body weight has a direct influence on glycaemic control by improving both hepatic and peripheral insulin sensitivity and decreasing insulin resistance (27). HbA1c is the accepted measure of longer-term glycaemic control with a level <7% as the desired target (28). While several studies of Type 2 diabetic subjects have demonstrated improvements in fasting blood glucose, HbA1c and plasma insulin after weight loss, it has been observed that the benefits are proportional to the amount of weight lost. A study by Wing et al. (29) showed that a weight loss of 10% of total body weight reduced HbA1c levels by 1.6%. Correspondingly, there was a reduction in the need for oral diabetic agents. In fact, those losing 15% of their body weight were able to discontinue medication for diabetes altogether.
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