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Living well with diabetes: 24-month outcomes from a randomized trial of telephone-delivered weight loss and physical activity intervention to improve glycemic control

Version 2 2024-06-03, 14:44
Version 1 2022-10-27, 04:58
journal contribution
posted on 2024-06-03, 14:44 authored by EG Eakin, EA Winkler, David DunstanDavid Dunstan, GN Healy, N Owen, AM Marshall, N Graves, MM Reeves
OBJECTIVE To evaluate the effectiveness of a telephone-delivered behavioral weight loss and physical activity intervention targeting Australian primary care patients with type 2 diabetes. RESEARCH DESIGN AND METHODS Pragmatic randomized controlled trial of telephone counseling (n = 151) versus usual care (n = 151). Reported here are 18-month (end-of-intervention) and 24-month (maintenance) primary outcomes of weight, moderate-to-vigorous-intensity physical activity (MVPA; via accelerometer), and HbA1c level. Secondary outcomes include dietary energy intake and diet quality, waist circumference, lipid levels, and blood pressure. Data were analyzed via adjusted linear mixed models with multiple imputation of missing data. RESULTS Relative to usual-care participants, telephone counseling participants achieved modest, but significant, improvements in weight loss (relative rate [RR] −1.42% of baseline body weight [95% CI −2.54 to −0.30% of baseline body weight]), MVPA (RR 1.42 [95% CI 1.06–1.90]), diet quality (2.72 [95% CI 0.55–4.89]), and waist circumference (−1.84 cm [95% CI −3.16 to −0.51 cm]), but not in HbA1c level (RR 0.99 [95% CI 0.96–1.02]), or other cardio-metabolic markers. None of the outcomes showed a significant change/deterioration over the maintenance period. However, only the intervention effect for MVPA remained statistically significant at 24 months. CONCLUSIONS The modest improvements in weight loss and behavior change, but the lack of changes in cardio-metabolic markers, may limit the utility, scalability, and sustainability of such an approach.

History

Journal

Diabetes Care

Volume

37

Pagination

2177-2185

Location

United States

ISSN

0149-5992

eISSN

1935-5548

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Issue

8

Publisher

AMER DIABETES ASSOC

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