Weight-Loss Counseling With Group Visits Improves HbA1c
Weight management/group medical visit arm had lower diabetes medication use, greater weight loss
WEDNESDAY, Nov. 6, 2019 (HealthDay News) -- The addition of intensive weight management (WM) to group medical visits (GMVs) for diabetes is noninferior for lowering hemoglobin A1c (HbA1c) levels and is associated with clinically important outcomes, according to a study published online Nov. 4 in JAMA Internal Medicine.
William S. Yancy Jr., M.D., from the Duke Diet & Fitness Center in Durham, North Carolina, and colleagues randomly assigned patients with type 2 diabetes, uncontrolled HbA1c, and a body mass index of ≥27 kg/m² to the GMV group (136 patients), which involved counseling with medication optimization, or the GMV/WM group (127 patients), which involved low-carbohydrate diet counseling with baseline medication reduction and subsequent medication optimization followed by an abbreviated GMV.
The researchers found HbA1c levels improved in both study arms at 48 weeks (8.2 and 8.3 percent in the WM/GMV and the GMV arms, respectively; mean difference, −0.1 percent; 95 percent confidence interval, −0.5 to 0.2 percent; P = 0.44). Compared with those in the GMV arm, patients in the WM/GMV arm had significantly lower diabetes medication use and significantly more weight loss at 48 weeks as well as fewer hypoglycemic events (incidence rate ratio, 0.49; 95 percent confidence interval, 0.27 to 0.71; P < 0.001).
"Given these benefits and the knowledge that lifestyle changes can be difficult to maintain, we should continue to develop strategies that help patients sustain these improvements," the authors write.