Feasibility study of portable technology for weight loss and HbA1c control in type 2 diabetes

BackgroundEvidence shows type 2 diabetes mellitus (T2DM) can be effectively treated with a reduced-carbohydrate diet to support weight loss. Digital apps are increasingly used to support weight loss, yet little is known about their use as part of general practice diabetes care.AimDetermine the feasibility of signposting from routine NHS general practice to a digital weight management tool (Low Carb Program) for patients with T2DM and pre-diabetes.Design/settingMixed-methods feasibility study implemented within routine general practice consultations at four practices in the Midlands, England.MethodsGeneral practices offered signposting to eligible patients attending consultations of any type during a four-week recruitment period. Rates of offering and accepting signposting were recorded, with program registration, program completion and self-reported health outcomes (weight, HbA1c).ResultsSignposting was offered to 351 patients; 160 (45.6%) accepted, 103 (29.3%) registered with the intervention and 43 (26.9% of patients accepting signposting) completed the programme. GPs reported that signposting added between 1–4 minutes to the consultation length. Patients completing the programme reported greater weight loss (7.2 kg vs 1.6 kg, P<.001) and HbA1c improvements (–9.1 mmol/mol vs 1.7 mmol/mol, P<.001) compared to those who did not, and were more likely to reduce the number of general practice-prescribed diabetes medications.ConclusionsSignposting from real-world general practice to the Low Carb Programme is feasible and can potentially improve diabetes outcomes. Further research should explore whether the process of signposting can be enhanced to increase registration, identify whether additional practice-led support leads to increased programme completion, and confirm the intervention’s clinical and cost-effectiveness.

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Abstract #806359: SGLT 2 Inhibitors; Glycemic Control, Weight Loss and Safety Profile in Patients with Type 2 Diabetes, at Medicell Institute: a Private Care Facility

Endocrine Practice ◽

10.1016/s1530-891x(20)39691-9 ◽

2020 ◽

Vol 26 ◽

pp. 126

Author(s):

Erum Sohail

Keyword(s):

Type 2 Diabetes ◽

Weight Loss ◽

Glycemic Control ◽

Safety Profile ◽

Care Facility ◽

Private Care

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How to Maintain a Healthy Body Weight

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831.76.4.208 ◽

2006 ◽

Vol 76 (4) ◽

pp. 208-215 ◽

Cited By ~ 10

Author(s):

Astrup

Keyword(s):

Physical Activity ◽

Type 2 Diabetes ◽

Weight Loss ◽

Body Weight ◽

Glycemic Index ◽

Dairy Products ◽

Weight Control ◽

Healthy Body Weight ◽

Healthy Body

The epidemic of both obesity and type 2 diabetes is due to environmental factors, but the individuals developing the conditions possess a strong genetic predisposition. Observational surveys and intervention studies have shown that excess body fatness is the major environmental cause of type 2 diabetes, and that even a minor weight loss can prevent its development in high-risk subjects. Maintenance of a healthy body weight in susceptible individuals requires 45–60 minutes physical activity daily, a fat-reduced diet with plenty of fruit, vegetables, whole grain, and lean meat and dairy products, and moderate consumption of calorie containing beverages. The use of table values to predict the glycemic index of meals is of little – if any – value, and the role of a low-glycemic index diet for body weight control is controversial. The replacement of starchy carbohydrates with protein from lean meat and lean dairy products enhances satiety, and facilitate weight control. It is possible that dairy calcium also promotes weight loss, although the mechanism of action remains unclear. A weight loss of 5–10% can be induced in almost all obese patients providing treatment is offered by a professional team consisting of a physician and dieticians or nurses trained to focus on weight loss and maintenance. Whereas increasing daily physical activity and regular exercise does not significantly effect the rate of weight loss in the induction phase, it plays an important role in the weight maintenance phase due to an impact on daily energy expenditure and also to a direct enhancement of insulin sensitivity.

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