David T Liss1, Emily A Finch2, Andrew Cooper2, Avani Sheth3, Ashantí D Tejuosho2, Nicola Lancki4, Ronald T Ackermann2. 1. Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States. Electronic address: david.liss@northwestern.edu. 2. Center for Community Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States; Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States. 3. Department of Family and Community Medicine, Cook County Health and Hospitals System, Chicago, IL, United States. 4. Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Abstract
AIMS: To estimate the real-world effects of offering a group-based lifestyle intervention (GLI) to adults with diabetes. METHODS: This randomized encouragement trial included adult primary care patients in metropolitan Chicago with type 2 diabetes and body mass index ≥24 kg/m2. Participants were randomized to standard care (brief dietary and lifestyle counseling) or standard care plus being encouraged, but not required, to participate in a free-of-charge GLI offered by the YMCA. The GLI was a group-based adaptation of the Look AHEAD lifestyle intervention. RESULTS: Of 331 participants, 167 were randomized to standard care and 164 to the GLI encouragement arm. About one third of participants were non-Hispanic White (34.4%). In the GLI arm, 75 (45.7%) attended ≥1 GLI visits. In the primary intention-to-treat analysis, the effect of GLI encouragement was 0.95% weight loss at six months (95% confidence interval [CI], 0.13-1.77%; P = 0.02), and 1.20% weight loss at 12 months (95% CI, 0.05-2.36%; P = 0.04). At 12 months, there was a 0.30% (3.3 mmol/mol) reduction in hemoglobin A1c, but this result did not achieve statistical significance (P = 0.054). In instrumental variable analysis estimating effects among the subgroup of participants who attended any GLI visits, the effect of GLI attendance was 2.30% weight loss at six months (95% CI, 0.30-4.30%; P = 0.02), and 2.07% weight loss at 12 months (95% CI, 0.25-3.88%; P = 0.02). We detected no significant blood pressure or cholesterol effects. CONCLUSIONS: Among adults with type 2 diabetes, a group-based lifestyle intervention in a community-based setting achieved modest weight loss at 6 and 12 months. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01435603.
RCT Entities:
AIMS: To estimate the real-world effects of offering a group-based lifestyle intervention (GLI) to adults with diabetes. METHODS: This randomized encouragement trial included adult primary care patients in metropolitan Chicago with type 2 diabetes and body mass index ≥24 kg/m2. Participants were randomized to standard care (brief dietary and lifestyle counseling) or standard care plus being encouraged, but not required, to participate in a free-of-charge GLI offered by the YMCA. The GLI was a group-based adaptation of the Look AHEAD lifestyle intervention. RESULTS: Of 331 participants, 167 were randomized to standard care and 164 to the GLI encouragement arm. About one third of participants were non-Hispanic White (34.4%). In the GLI arm, 75 (45.7%) attended ≥1 GLI visits. In the primary intention-to-treat analysis, the effect of GLI encouragement was 0.95% weight loss at six months (95% confidence interval [CI], 0.13-1.77%; P = 0.02), and 1.20% weight loss at 12 months (95% CI, 0.05-2.36%; P = 0.04). At 12 months, there was a 0.30% (3.3 mmol/mol) reduction in hemoglobin A1c, but this result did not achieve statistical significance (P = 0.054). In instrumental variable analysis estimating effects among the subgroup of participants who attended any GLI visits, the effect of GLI attendance was 2.30% weight loss at six months (95% CI, 0.30-4.30%; P = 0.02), and 2.07% weight loss at 12 months (95% CI, 0.25-3.88%; P = 0.02). We detected no significant blood pressure or cholesterol effects. CONCLUSIONS: Among adults with type 2 diabetes, a group-based lifestyle intervention in a community-based setting achieved modest weight loss at 6 and 12 months. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT01435603.
Authors: Rena R Wing; Paula Bolin; Frederick L Brancati; George A Bray; Jeanne M Clark; Mace Coday; Richard S Crow; Jeffrey M Curtis; Caitlin M Egan; Mark A Espeland; Mary Evans; John P Foreyt; Siran Ghazarian; Edward W Gregg; Barbara Harrison; Helen P Hazuda; James O Hill; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; Abbas E Kitabchi; William C Knowler; Cora E Lewis; Barbara J Maschak-Carey; Maria G Montez; Anne Murillo; David M Nathan; Jennifer Patricio; Anne Peters; Xavier Pi-Sunyer; Henry Pownall; David Reboussin; Judith G Regensteiner; Amy D Rickman; Donna H Ryan; Monika Safford; Thomas A Wadden; Lynne E Wagenknecht; Delia S West; David F Williamson; Susan Z Yanovski Journal: N Engl J Med Date: 2013-06-24 Impact factor: 91.245
Authors: Donna H Ryan; Mark A Espeland; Gary D Foster; Steven M Haffner; Van S Hubbard; Karen C Johnson; Steven E Kahn; William C Knowler; Susan Z Yanovski Journal: Control Clin Trials Date: 2003-10
Authors: J Rushing; R Wing; T A Wadden; W C Knowler; M Lawlor; M Evans; T Killean; M Montez; M A Espeland; P Zhang Journal: Obes Sci Pract Date: 2017-02-24
Authors: Julia Simões Corrêa Galendi; Renata Giacomini Occhiuto Ferreira Leite; Luísa Rocco Banzato; Vania Dos Santos Nunes-Nogueira Journal: Int J Environ Res Public Health Date: 2022-04-02 Impact factor: 3.390
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