Clinical Outcomes in Patients with Diabetes Mellitus Using a Medically Supervised Commercial Weight Reduction Program Compared to Standard Care in an Endocrine Specialty Clinic
R.C. Kennedy1*, A. Inankur1, A. Qureshi1, K.J, McQuerry2, L.R. Reynolds1
Affiliation
- 1Division of Endocrinology and Metabolism, University of Kentucky, Lexington, KY
- 2Department of Statistics, University of Kentucky
Corresponding Author
R.C. Kennedy, Division of Endocrinology and Metabolism, University of Kentucky, Lexington, KY, E-mail: rckennedy@live.com
Citation
Kennedy, R.C., et al. Clinical Outcomes in Patients with Diabetes Mellitus Using a Medically Supervised Commercial Weight Reduction Program Compared to Standard Care in an Endocrine Specialty Clinic. (2016) J Diab Obes 3(2): 51- 56.
Copy rights
© 2016 Kennedy, R.C. This is an Open access article distributed under the terms of Creative Commons Attribution 4.0 International License.
Abstract
Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patients (pts) in a structured weight loss (WL) program vs usual care in an endocrine clinic (UCG).
Materials and Methods: This retrospective comparison study examined 38 diabetic pts with BMI >25 undergoing the active weight loss phase of WL determined by patient goal weight and then followed for 6 months in weight maintenance phase (WM). Multiple endpoints were assessed at baseline including BMI and hemoglobin A1c (A1c). Endpoints were reassessed at 6 months in WM. The usual care group (UCG) was obtained through chart review of 26 diabetic pts with BMI > 25 in an endocrine specialty clinic who completed an education program including lifestyle counseling by a certified diabetic educator. Data were analyzed using ANCOVA and protected LSD, adjusting for age, gender, and baseline weight.
Results: Patients showed a change in BMI at 6 months of -6.8 ± 0 (bsl 44 ± 8.4) and -0.7 ± 1.1 (bsl 35 ± 6.2) for HMR® pts and UCG, respectively (p < 0.05). HMR® pts had 13.4% ± 3 % WL vs 7.9% ± 4% in UCG p = 0.34). 6 month A1c was similar in HMR pts (7.5% ± 2; bsl 8.3 ± 1.9) and UCG (7.5% ± 2.3; bsl 9.8 ± 1.8). HMR® pts had a reduction of total medication usage of 28%, with at least one medication discontinued in 80% of pts, while the UCG had only 23% of pts with discontinuation of at least one medication (p < 0.05).
Conclusions: Compared to CDE-led diabetic education emphasizing lifestyle change, pts in an intensive WL program utilizing weekly coaching, meal replacements, and exercise, had a significant decrease in BMI and achieved a similar A1c with reduction in medication requirements.
