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Delahanty, L. M., Dalton, K. M., Porneala, B., Chang, Y., Goldman, V. M., Levy, D., ... &  Wexler, D. J. (2015). Improving diabetes outcomes through lifestyle change– A randomized controlled trial. Obesity, 23(9), 1792-1799.

Improving Diabetes Outcomes Through Lifestyle Change- A Randomized Controlled Trial
The increasingly prevalent issue of obesity has become a costly public health problem, which faces our entire nation and gives rise to an epidemic of type II diabetes and other adverse health problems. One way to prevent prediabetes and treat diabetes is to focus on achieving long-term weight loss. There is a type II diabetes trial called Look AHEAD, which includes an intensive lifestyle intervention (ILI) which resulted in sustained weight loss with improved glycemic control, reduced medication use and cost, and better quality of life when compared to standard diabetes education. The authors of this research adapted Look AHEAD’s concepts and use of an ILI and dietitian-led group session style. Their hypothesis was that a 19-week group lifestyle intervention would be more effective for weight loss of 6 months than dietitian-referral MNT, which is the current reimbursed standard of care in this population.

There were two separate interventions given to study participants. Participants assigned to the MNT group sat with dietitians to review an educational handout, which described benefits of modest weight loss and increasing physical activity. Participants assigned to the group lifestyle intervention attended 19 weekly 1.5-hour group sessions led by dietitians. Results did indeed show that a 19-week group lifestyle intervention was significantly more effective than dietitian-referral MNT when it comes to achieving weight loss in patients with type II diabetes. Additionally, the group lifestyle intervention was seen to result in improved glycemic control and significant medication reduction. Although dietitian-referral, the current reimbursed standard of care, did result in weight loss and some improvement in glycemic control, a more comprehensive dietitian-led group lifestyle intervention that includes for contact time with healthcare professionals can offer a viable model of care at a reasonable cost to eligible patients. The average price of the group lifestyle intervention is around $570, which is comparable to programs like Weight Watchers (doesn’t include weekly physician medication titration and oversight). Results of this study show that a group lifestyle intervention can be effectively translated as a usual standard of care.

KS 

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