scholarly journals Type 2 diabetes is an independent predictor of weight loss in Tier 3 Weight Assessment and Management Services

2020 ◽  
Vol 20 (2) ◽  
pp. 117-121
Author(s):  
Aliya Syahreni Prihartadi* ◽  
Giovanna Impelliziere Licastro* ◽  
Harshal Deshmukh ◽  
Sufyan Benamer ◽  
Kyaw Linn ◽  
...  

Introduction: A specialist weight management service provides an effective treatment option for severe obesity; however, there are limited data exploring the baseline predictors of response and effect on HbA1c following engagement with the service.Methods: We used prospective data from the regional weight management services within the Hull University Teaching Hospitals NHS Trust Tier 3 Obesity Programme. Data were available for 249 patients referred to the service. T-tests were used for univariate baseline characteristics of those with and without 5% weight loss after engagement with the service. Logistic regression analysis was used to identify independent predictors of weight loss at 12 months.Results: A total of 309 patients were referred to the Tier 3 adult weight management service, of which 249 (80.6%) participated in the programme and had at least one follow-up. The median age of the study population was 46 years (range 36–55) and consisted of 66% females with a median baseline body mass index of 44 kg/m2 (range 42–45). The prevalence of type 2 diabetes was 31%, hypertension was 35%, gastro-oesophageal reflux disease was 34% and osteoarthritis was 29%. The median baseline weight on enrolment in the programme was 126 kg (range 115–138). During the follow-up period of 1 year, the median weight fell to 120.5 kg at 3 months, 119.6 kg at 6 months, 117.7 kg at 9 months and 117.5 kg at 12 months. The median HbA1c fell from a baseline of 60.25 mmol/mol to 54.4 mmol/mol during the follow-up period. Sixty-four patients had a baseline HbA1c of >53 mmol/mol (7% HbA1c), which fell to <53 mmol/mol in 21% of patients during the follow-up period. In the logistic regression model, higher age (OR 1.05, p=0.0001), type 2 diabetes (OR 2.54, p=0.002) and dyslipidaemia (OR 2.21, p=0.03) were independently associated with more than 5% weight loss at 12 months follow-up.Conclusion: Engagement with Tier 3 adult weight management is associated with significant weight loss and improvement in glycaemic control in a large proportion of patients at one year. Higher age, diabetes and dyslipidaemia at baseline are independent predictors of weight loss on the Tier 3 weight management service.

2020 ◽  
Author(s):  
H Deshmukh ◽  
S Benamer ◽  
K Linn ◽  
T Sathyapalan ◽  
K Mohammed

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Clare England ◽  
Sam Leary ◽  
Catherine Thompson ◽  
Claire Lorimer ◽  
Rob Andrews

AbstractThe UK Diabetes and Diet Questionnaire (UKDDQ) is a brief dietary questionnaire developed for people with, or at high risk of, type 2 diabetes(1). It consists of 20 items scored from 0–5 (0 healthiest, 5 least healthy). It has been demonstrated to be reliable and compares well with food diaries. A study evaluating sensitivity to change of the UKDDQ was undertaken at the specialist weight management service (WMS) at Musgrove Park Hospital, Taunton. WMS patients receive an initial appointment with an endocrinologist and dietitian, followed by referral to group sessions or dietary advice. Follow up appointments with a WMS specialist occur over the next 26 weeks. Adults attending the service were recruited for the study between September 2016-March 2017. Participants completed the UKDDQ in the waiting room at the initial appointment and the first follow-up. Diabetes status, binge eating assessment and weight at both timepoints were obtained from WMS records. UKDDQ scores from 0–5 were calculated for each participant by summing the score for each item and dividing by 20. Change in UKDDQ scores and absolute and percentage change in weight between appointments were calculated. Paired sample t-tests were used to test differences in means for UKDDQ scores and weight from baseline to follow up. Multivariable regression analysis was used to examine associations between changes in the UKDDQ scores and percentage change in weight. The model was adjusted for age, gender, follow up time, diabetes status and binge eating. Forty-eight White British participants completed the study (67% women, 37% type 2 diabetes, 29% binge eating). Baseline mean weight was 132.4 (29.4)kg, mean BMI 46.5(7.7)kg/m2 and mean UKDDQ score was 1.39 (0.49). Participants lost weight (-2.4 (6.9)kg, p = 0.006) and the UKDDQ score improved between baseline and follow up (-0.27(0.53), p = 0.001). The mean percentage weight change was -1.6 (5.0)%. There was some evidence that a one point deterioration in healthy eating was associated with a 2.4 (-0.2 to 5.1)% increase in weight (p = 0.072). The UKDDQ can measure dietary change in people attending a specialist WMS and there is some evidence that a change in score is associated with a change in weight. The UKDDQ could be used as an outcome measure in these services.


Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 564-P
Author(s):  
DANIEL COX ◽  
MATTHEW A. MONCRIEF ◽  
ANTHONY L. MCCALL

2019 ◽  
Vol 7 (1) ◽  
pp. e000659 ◽  
Author(s):  
Shaheen Tomah ◽  
Noor Mahmoud ◽  
Adham Mottalib ◽  
David M Pober ◽  
Mhd Wael Tasabehji ◽  
...  

ObjectiveWe evaluated the relationship between frequency of self-monitoring of blood glucose (SMBG) and body weight, A1C, and cardiovascular risk factors in patients with type 2 diabetes (T2D) and obesity enrolled in a 12-week intensive multidisciplinary weight management (IMWM) program.Research design and methodsWe conducted a retrospective analysis of 42 patients who electronically uploaded their SMBG data over 12 weeks of an IMWM program and divided them into tertiles based on their average frequency of SMBG per day. Mean (range) SMBG frequencies were 2.3 (1.1–2.9) times/day, 3.4 (3–3.9) times/day, and 5 (4–7.7) times/day in the lowest, middle, and highest tertiles, respectively. Anthropometric and metabolic parameters were measured at baseline and after 12 weeks of intervention.ResultsParticipants in the highest tertile achieved a median change (IQR) in body weight of −10.4 kg (−7.6 to −14.4 kg) compared with −8.3 kg (−5.2 to −12.2 kg), and −6.9 kg (−4.2 to −8.9 kg) in the middle and lowest tertiles, respectively (p=0.018 for trend). Participants in the highest tertile had a median change (IQR) in A1C of −1.25% (−0.6 to −3.1%) compared with −0.8% (−0.3% to −2%) and −0.5% (−0.2% to −1.2%) in the middle and lowest tertiles, respectively (p=0.048 for trend). The association between change in body weight and SMBG frequency remained significant after adjusting for age, sex, baseline body mass index, diabetes duration, and use of insulin therapy.ConclusionsIncreased frequency of SMBG during IMWM is associated with significantly better weight loss and improvement of A1C in patients with T2D and obesity. These findings may suggest future clinical recommendations aimed at increasing SMBG frequency to achieve the most favorable outcomes.


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