Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes.

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  • Additional Information
    • Source:
      Publisher: Published by BMJ in partnership with the American Diabetes Association Country of Publication: England NLM ID: 101641391 Publication Model: eCollection Cited Medium: Print ISSN: 2052-4897 (Print) Linking ISSN: 20524897 NLM ISO Abbreviation: BMJ Open Diabetes Res Care
    • Publication Information:
      Original Publication: London : Published by BMJ in partnership with the American Diabetes Association
    • Subject Terms:
      Body Mass Index* ; Weight Loss*; Behavior Therapy/*methods ; Biomarkers/*analysis ; Diabetes Mellitus, Type 2/*therapy ; Obesity/*therapy ; Prediabetic State/*therapy; Adult ; Aged ; Blood Glucose/analysis ; Body Weight ; Case-Control Studies ; Diabetes Mellitus, Type 2/psychology ; Energy Intake ; Female ; Follow-Up Studies ; Glycated Hemoglobin/analysis ; Humans ; Male ; Middle Aged ; Obesity/psychology ; Prediabetic State/psychology ; Treatment Outcome ; Young Adult
    • Abstract:
      Objective: This study examined the effects of three doses of behavioral weight loss treatment, compared with a nutrition education control group, on changes in glycemic control in individuals with obesity and prediabetes.
      Research Design and Methods: The study included 287 adults (77% female, 81% White; mean (SD) age=54.1 (10.5) years, body mass index=36.3 (3.9) kg/m 2 , and hemoglobin A1c (HbA1c)=5.9 (0.2%)). Participants were randomized to one of three behavioral treatment doses (high=24 sessions, moderate=16 sessions, or low=8 sessions) or to an education group (control=8 sessions). Changes in HbA1c, fasting glucose, and body weight were assessed from baseline to 6 months.
      Results: Mean (99.2% credible interval (CI)) reductions in HbA1c were 0.11% (0.07% to 0.16%), 0.08% (0.03% to 0.13%), 0.03% (-0.01% to 0.07%), and 0.02% (-0.02% to 0.07%), for the high, moderate, low, and control conditions, respectively. Mean (CI) reductions in fasting blood glucose were 0.26 mmol/L (0.14 to 0.39), 0.09 mmol/L (0 to 0.19), 0.01 mmol/L (-0.07 to 0.09), and 0.04 mmol/L (-0.03 to 0.12) for the high, moderate, low, and control conditions, respectively. The high-dose treatment produced significantly greater reductions in HbA1c and fasting blood glucose than the low-dose and control conditions (posterior probabilities (pp)<0.001); no other significant between-group differences were observed. Mean (CI) reductions in body weight were 10.91 kg (9.30 to 12.64), 10.08 kg (8.38 to 11.72), 6.35 kg (5.19 to 7.69), and 3.82 kg (3.04 to 4.54) for the high, moderate, low, and control conditions, respectively. All between-group differences in 6-month weight change were significant (pps<0.001) except for the high-dose versus moderate-dose comparison.
      Conclusion: For adults with obesity and prediabetes a high dose of behavioral treatment involving 24 sessions over 6 months may be needed to optimize improvements in glycemic control.
      Trial Registration Number: NCT00912652.
      Competing Interests: Competing interests: None declared. DX participated in the study while working at the University of Texas at Austin, prior to her current affiliation with the US Food and Drug Administration (FDA). Thus, study findings and conclusions were not formally disseminated by the FDA and should not be construed to represent an agency decision or policy.
    • References:
      MMWR Morb Mortal Wkly Rep. 2013 Mar 22;62(11):209-12. (PMID: 23515058)
      Ann Intern Med. 2003 Dec 2;139(11):933-49. (PMID: 14644897)
      Diabetes Care. 2018 Jan;41(Suppl 1):S1-S2. (PMID: 29222369)
      Fam Community Health. 2010 Apr-Jun;33(2):133-43. (PMID: 20216356)
      J Clin Endocrinol Metab. 2004 Jun;89(6):2583-9. (PMID: 15181027)
      N Engl J Med. 2005 Nov 17;353(20):2111-20. (PMID: 16291981)
      Diabetes Care. 2002 Dec;25(12):2165-71. (PMID: 12453955)
      Health Psychol. 2000 Jan;19(1S):5-16. (PMID: 10709944)
      Lancet. 2012 Jun 16;379(9833):2279-90. (PMID: 22683128)
      Diabetes Care Educ Newsl. 2012 Summer;33(4):4-7. (PMID: 26451082)
      J Clin Endocrinol Metab. 2016 Nov;101(11):4076-4084. (PMID: 27533307)
      Diabetes Care. 2006 Sep;29(9):2102-7. (PMID: 16936160)
      Psychiatr Clin North Am. 2011 Dec;34(4):841-59. (PMID: 22098808)
      Health Educ Behav. 2008 Oct;35(5):634-50. (PMID: 17200103)
      Diabet Med. 2017 May;34(5):632-640. (PMID: 28075544)
      Ger Med Sci. 2003 Jul 01;1:Doc04. (PMID: 19675702)
      J Consult Clin Psychol. 1989 Jun;57(3):450-2. (PMID: 2500466)
      JAMA. 2018 Sep 18;320(11):1163-1171. (PMID: 30326502)
      J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2985-3023. (PMID: 24239920)
      Curr Opin Endocrinol Diabetes Obes. 2009 Apr;16(2):113-8. (PMID: 19300091)
      Am J Med. 2013 Mar;126(3):236-42, 242.e1-2. (PMID: 23410564)
      Obesity (Silver Spring). 2014 Jan;22(1):5-13. (PMID: 24307184)
      N Engl J Med. 2002 Feb 7;346(6):393-403. (PMID: 11832527)
      Obesity (Silver Spring). 2014 Nov;22(11):2293-300. (PMID: 25376396)
      Ann Behav Med. 2014 Dec;48(3):392-401. (PMID: 24722964)
      J Clin Endocrinol Metab. 2011 Jun;96(6):1654-63. (PMID: 21602457)
      J Epidemiol Community Health. 2000 Aug;54(8):596-602. (PMID: 10890871)
    • Grant Information:
      R01 CA183854 United States CA NCI NIH HHS; R01 HL087800 United States HL NHLBI NIH HHS
    • Contributed Indexing:
      Keywords: behavioral treatment; glycemic control; obesity; weight loss
    • Molecular Sequence:
      ClinicalTrials.gov NCT00912652
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20190628 Date Completed: 20200422 Latest Revision: 20221207
    • Publication Date:
      20231215
    • Accession Number:
      PMC6557466
    • Accession Number:
      10.1136/bmjdrc-2019-000653
    • Accession Number:
      31245006