Rights statement: This is the peer reviewed version of the following article: Botha, S, Forde, L, MacNaughton, S, et al. Effect of non‐surgical weight management on weight and glycaemic control in people with type 2 diabetes: A comparison of interventional and non‐interventional outcomes at 3 years. Diabetes Obes Metab. 2018; 20: 879– 888. https://doi.org/10.1111/dom.13171 which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/dom.13171 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Accepted author manuscript, 3.97 MB, PDF document
Available under license: CC BY-NC: Creative Commons Attribution-NonCommercial 4.0 International License
Final published version
Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
}
TY - JOUR
T1 - Effect of non-surgical weight management on weight and glycaemic control in people with type 2 diabetes
T2 - A comparison of interventional and non-interventional outcomes at 3 years
AU - Botha, Shani
AU - Forde, Lorna
AU - MacNaughton, Sheila
AU - Shearer, Ross
AU - Lindsay, Robert
AU - Sattar, Naveed
AU - Morrison, David
AU - Welsh, Paul
AU - Logue, Jennifer
N1 - This is the peer reviewed version of the following article: Botha, S, Forde, L, MacNaughton, S, et al. Effect of non‐surgical weight management on weight and glycaemic control in people with type 2 diabetes: A comparison of interventional and non‐interventional outcomes at 3 years. Diabetes Obes Metab. 2018; 20: 879– 888. https://doi.org/10.1111/dom.13171 which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1111/dom.13171 This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
PY - 2018/4/11
Y1 - 2018/4/11
N2 - AimsTo examine the long‐term effectiveness of lifestyle weight management interventions, recommended in clinical guidelines for patients with type 2 diabetes mellitus (T2DM) and obesity.Materials and methodsElectronic health records were used to follow 23 208 patients with T2DM and obesity in Glasgow, UK, for up to 3 years between 2005 and 2014. Patients were stratified by referral to and attendance at a lifestyle weight management intervention, and by attainment of a target weight loss of ≥5 kg over 7 to 9 sessions (“successful completers”). Outcomes were change in weight, glycated haemoglobin (HbA1c) and diabetes medications.ResultsA total of 3471 potentially eligible patients were referred to the service, and fewer than half of these attended (n = 1537). Of those who attended 7 to 9 sessions, >40% successfully completed and achieved 5‐kg weight loss (334/808). Successful completers maintained greater weight loss (change at 3 years −8.03 kg; 95% confidence interval [CI] −9.44 to −6.62) than the non‐completers (−3.26 kg; 95% CI −4.01 to −2.51; P < .001) and those not referred to the service (−1.00 kg; 95% CI −1.15 to −0.85; P < .001). Successful completers were the only patient group who did not increase their use of diabetes medication and insulin over 3 years. In adjusted models, successful completers had a clinically significant reduction in HbA1c (−3.7 mmol/mol; 95% CI −5.82 to −1.51) after 3 years; P ≤ .001) compared with non‐completers and unsuccessful completers.ConclusionsA real‐life structured weight management intervention in patients with diabetes can reduce weight in the medium term, result in improved glycaemic control with fewer medications, and may be more effective than pharmacological alternatives. Challenges include getting a higher proportion of patients referred to and engaged with interventions.
AB - AimsTo examine the long‐term effectiveness of lifestyle weight management interventions, recommended in clinical guidelines for patients with type 2 diabetes mellitus (T2DM) and obesity.Materials and methodsElectronic health records were used to follow 23 208 patients with T2DM and obesity in Glasgow, UK, for up to 3 years between 2005 and 2014. Patients were stratified by referral to and attendance at a lifestyle weight management intervention, and by attainment of a target weight loss of ≥5 kg over 7 to 9 sessions (“successful completers”). Outcomes were change in weight, glycated haemoglobin (HbA1c) and diabetes medications.ResultsA total of 3471 potentially eligible patients were referred to the service, and fewer than half of these attended (n = 1537). Of those who attended 7 to 9 sessions, >40% successfully completed and achieved 5‐kg weight loss (334/808). Successful completers maintained greater weight loss (change at 3 years −8.03 kg; 95% confidence interval [CI] −9.44 to −6.62) than the non‐completers (−3.26 kg; 95% CI −4.01 to −2.51; P < .001) and those not referred to the service (−1.00 kg; 95% CI −1.15 to −0.85; P < .001). Successful completers were the only patient group who did not increase their use of diabetes medication and insulin over 3 years. In adjusted models, successful completers had a clinically significant reduction in HbA1c (−3.7 mmol/mol; 95% CI −5.82 to −1.51) after 3 years; P ≤ .001) compared with non‐completers and unsuccessful completers.ConclusionsA real‐life structured weight management intervention in patients with diabetes can reduce weight in the medium term, result in improved glycaemic control with fewer medications, and may be more effective than pharmacological alternatives. Challenges include getting a higher proportion of patients referred to and engaged with interventions.
U2 - 10.1111/dom.13171
DO - 10.1111/dom.13171
M3 - Journal article
VL - 20
SP - 879
EP - 888
JO - Diabetes, Obesity and Metabolism
JF - Diabetes, Obesity and Metabolism
SN - 1462-8902
IS - 4
ER -