Improving diabetes outcomes through lifestyle change--A randomized controlled trial

Area of Science:

• Endocrinology
• Metabolic Diseases
• Public Health

Background:

• Type 2 diabetes management often requires lifestyle interventions for weight loss.
• Dietitian referral for medical nutrition therapy (RD) is a common approach.
• Group lifestyle interventions (GLI) offer a potentially scalable alternative.

Purpose of the Study:

• To compare the effectiveness of a GLI versus RD for weight loss in type 2 diabetes patients.
• To evaluate changes in glycemic control, medications, and cardiac risk factors.
• To conduct a cost analysis of the GLI program.

Main Methods:

• A randomized clinical trial involving 57 primary care patients with type 2 diabetes and BMI >25 kg/m².
• Participants were assigned to either a 19-week dietitian-led GLI or RD.
• Outcome measures included weight loss at 6 months and 1 year, medication changes, glycemic control, and cost.

Main Results:

• At 6 months, 46% of GLI participants lost ≥5% body weight compared to 21% in RD (P=0.04).
• Mean weight loss was significantly greater in GLI (6.6 kg) vs. RD (2.1 kg) at 6 months (P=0.004) and sustained at 1 year.
• 82% of GLI participants reduced or stopped diabetes medications vs. 38% in RD (P<0.001).

Conclusions:

• An affordable group lifestyle intervention (GLI) is more effective than dietitian referral for medical nutrition therapy (RD) for weight loss in type 2 diabetes patients.
• GLI promotes significant medication reduction in this population.
• GLI represents a cost-effective intervention for type 2 diabetes management in primary care.