Improving diabetes outcomes through lifestyle change--A randomized controlled trial
Linda M Delahanty, Kristen M Dalton, Bianca Porneala, Yuchiao Chang, Valerie M Goldman, Douglas Levy, David M Nathan, Deborah J Wexler, Linda M Delahanty, Kristen M Dalton, Bianca Porneala, Yuchiao Chang, Valerie M Goldman, Douglas Levy, David M Nathan, Deborah J Wexler
Abstract
Objective: To compare a diabetes group lifestyle intervention (GLI) with dietitian referral for medical nutrition therapy (RD) for weight loss in the usual care setting.
Methods: Randomized clinical trial was conducted with 57 primary care patients with type 2 diabetes and body mass index (BMI) >25 kg/m(2) who received either a dietitian-led 19-week GLI adapted from the Look AHEAD study or RD. Outcome measures include 6-month and 1-year weight loss, changes in medications, glycemic control, cardiac risk factors, and cost analysis.
Results: Patients were mean age 61, 59% male, and 32% non-white, and they weighed 97 kg with mean HbA1c 8.2%. At 6 months, 46% of GLI vs. 21% of RD lost ≥5% body weight (P = 0.04), with mean weight loss 6.6 (SD 7.0) kg with GLI and 2.1 (3.5) kg in RD (P = 0.004). HbA1c improved by 0.70 (1.13) vs. 0.39 (1.51) in GLI vs. RD (P = 0.4), respectively, and 82% vs. 38% stopped or reduced diabetes medications (P < 0.001). Weight loss remained significantly greater in GLI compared to RD at 1 year. GLI program cost was $578 per participant.
Conclusions: An affordable GLI achieved significantly more weight loss and medication reduction than RD in primary care patients with type 2 diabetes.
Trial registration: ClinicalTrials.gov NCT01665989.
© 2015 The Obesity Society.
Source: PubMed