Community-based weight-loss program improved diabetes symptoms
Participation in structured, community-based weight-loss programs helps patients with diabetes shed pounds, improve blood glucose levels and reduce or even eliminate the need for insulin or other medications, according to research published in Diabetes Care.
In a year-long randomized controlled trial, Cheryl L. Rock, PhD, RD, of the University of California, San Diego (UCSD) and colleagues enrolled 227 adults (aged ≥18 years; BMI, 25-45) with diabetes at UCSD and the University of Minnesota, Minneapolis. Participants had no history of weight-loss surgery; exclusion criteria included HbA1c >11% (>97 mmol/mol), fasting triglycerides >600 mg/dL and serum creatinine >1.4 mg/dL in women or 1.5 mg/dL in men.
Patients were assigned to one of two structured programs — higher carbohydrate, lower fat or lower carbohydrate, higher fat — or usual care to determine the respective effect on weight loss, glycemic control and improved cardiovascular risk factors, stratified by study site and BMI.
The structured program offered diabetes self-management education, weight counseling, portion-controlled food, a planned menu during the first 6 months, and continued one-on-one counseling for the 1-year study period — all provided by Jenny Craig. The usual care included general diabetes management education, a 1-hour individual weight-loss counseling session with a dietitian at the start of the program and again at 6 months, as well as monthly follow-up consultations via email or telephone.
Relative weight loss was 7.4% (95% CI, 5.7-9.2), 9% (95% CI, 7.1-10.9) and 2.5% (95% CI, 1.3-3.8) for lower fat, lower carbohydrate, and usual care groups, respectively (P<.001 intervention effect).
At 1-year follow-up, intervention groups were lower than control groups for glycemic control markers and triglycerides:
- 141 mg/dL fasting glucose (95% CI, 133-149) vs. 159 (95% CI, 144-174) mg/dL fasting glucose, P=.01;
- 6.9% HbA1c (95% CI, 6.6-7.1) vs. 7.5% (95% CI, 7.1-7.9) HbA1c, P=.001;
- 148 mg/dL triglycerides (95% CI, 134-163) vs. 204 (95% CI, 173-234) mg/dL triglycerides, P<.001.
“These study results suggest that patients not only lose weight on structured commercial weight loss programs that include behavioral modification and individual support,” Rock said in a press release, “but that this weight loss translates to significant improvements in diabetes control and cardiometabolic parameters.”
Disclosure: The study was supported by Jenny Craig. Funding was provided through a clinical trial contract to the School of Medicine at University of California, San Diego.