Linda M Delahanty1,2, Kristen M Dalton1, Bianca Porneala3, Yuchiao Chang2,3, Valerie M Goldman1, Douglas Levy2,4, David M Nathan1,2, Deborah J Wexler1,2. 1. Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA. 2. Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA. 3. Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA. 4. Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA.
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 meanHbA1c 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.
RCT Entities:
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.
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Authors: Linda M Delahanty; Douglas E Levy; Yuchiao Chang; Bianca C Porneala; Valerie Goldman; Jeanna McCarthy; Laurie Bissett; Anthony Romeo Rodriguez; Barbara Chase; Rajani LaRocca; Amy Wheeler; Deborah J Wexler Journal: J Gen Intern Med Date: 2020-01-21 Impact factor: 5.128