Tailored diabetes education with behavioral weight management bests standard care
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Key takeaways:
- Adults were more likely to achieve diabetes remission with behavioral weight management combined with diabetes education.
- A combined intervention is more cost-effective than standard diabetes education alone.
DALLAS —Behavioral weight management combined with diabetes education is linked to greater weight loss and a higher likelihood for diabetes remission for adults with new-onset type 2 diabetes, according to two speakers at ObesityWeek.
In a randomized controlled trial conducted in the U.K., adults with overweight or obesity who were newly diagnosed with type 2 diabetes were randomly assigned to an intervention with joint behavioral weight management and remote dietary counseling or standard care diabetes education. At 6 months and 1 year, the intervention group lost more weight than the standard care group, though HbA1c was not different between the two arms.
“For people living with overweight and obesity who have a new diagnosis of type 2 diabetes, referral to a program combining diabetes education with behavioral weight management could help them to achieve weight loss and diabetes remission compared with diabetes education alone,” Julia Mueller, PhD, research associate in the MRC epidemiology unit at the University of Cambridge in the U.K., and Amy Ahern, PhD, principal research associate in the MRC epidemiology unit at the University of Cambridge, told Healio. “Although the tailored program is more expensive, the program is likely to be cost-effective over the longer term because of reductions in weight-related diseases and associated health care costs.”
Researchers conducted a parallel, single-blind randomized controlled trial enrolling 577 adults aged 18 years and older with overweight and obesity who had been diagnosed with type 2 diabetes within the past 3 years. Adults were randomly assigned to tailored diabetes education with a WW behavioral weight management program or standard care diabetes education. HbA1c, body weight, behavioral measures and psychosocial measures were collected at baseline, 6 months and 12 months.
Of the participants, 398 completed the 12-month follow-up. The change in HbA1c was similar in the two groups at 6 and 12 months. The behavioral weight-management group lost 1.87 kg more weight at 6 months and 1.41 kg more weight at 12 months compared with the standard care group. Adults participating in the intervention were more likely to achieve diabetes remission at 6 (RR = 2.1; 95% CI, 1.03-4.47) and 12 months (RR = 2.53; 95% CI, 1.3-5.16) than those receiving standard care.
Researchers also conducted a microsimulation model to estimate incremental lifetime health care costs and quality-adjusted life-years. Diabetes education with a behavioral weight-management program has an estimated cost per life-year of about £2,058, or the equivalent of about $2,505. Ahern said the National Health Service in the U.K. is willing to pay £20,000 per quality-adjusted life-year for health care interventions.
“Participants were recruited via U.K. primary care practices and both of the interventions we evaluated are available for commissioning in the U.K,” Mueller and Ahern said. “The tailored diabetes education and weight management program was more expensive than the diabetes education program, which may make commissioners less likely to choose this. However, when we modeled the impact of the interventions on health and health care costs over a lifetime, we showed that investing in the more expensive program would be cost-effective because of the greater improvements in health and quality of life and the associated reduction in other health care costs. This indicates that the new program would be suitable for implementation in the U.K. National Health Service.”
Mueller and Ahern said more research is needed to analyze how this type of program could meet the needs of other groups of people as well as the collect longer-term data.
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Mueller J, et al. Oral-104. Presented at: ObesityWeek; Oct. 14-17, 2023; Dallas.
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