medwireNews: A partnership between primary care and commercial weight management providers could help reduce the risk for type 2 diabetes among patients with hyperglycemia, UK study findings show.
Among 117 individuals with nondiabetic hyperglycemia referred by their general practitioner (GP) to the Weight Watchers Diabetes Prevention Program, the average reduction in glycated hemoglobin at 12 months was a significant 2.84 mmol/mol, from 43.42 mmol/mol at baseline.
Normoglycemia was achieved by 38% of patients and 15% reduced their risk for diabetes by reducing their blood glucose. Just 3% of patients developed type 2 diabetes.
The mean weight loss was 10 kg and BMI decreased by an average of 3.2 kg/m2, from 35.5 kg/m2 at baseline. Just over half of the patients had lost more than 7% of their bodyweight at 6 and 12 months.
“The lifestyle changes and weight loss achieved in the intervention translated into considerable reductions in diabetes risk, with an immediate and significant public health impact,” Carolyn Piper (Department of Public Health, London Borough Bromley, UK) and colleagues report in BMJ Open Diabetes Research & Care.
They add that the results match those of optimal interventions and “represent clinical success” according to the findings of a Public Health England meta-analysis.
There were also improvements in cardiovascular risk factors, with significant reductions in blood pressure, triglycerides, ratio of cholesterol to high-density lipoprotein (HDL), and a significant increase in HDL among men over the course of the study.
The intervention comprised a structured 90-minute activation session on diabetes prevention, including weight loss, increasing and accurately recording physical activity, motivating commitment to change, and measuring weight circumference. This was followed by the standard evidence-based Weight Watchers Diabetes Prevention Program for 48 weeks. Blood tests continued to be taken by the GP at 6 and 12 months.
The team notes that the intervention was taken up by 77% of eligible referrals, and an average of 29 sessions were attended out of a possible 48.
“The main strength of this study was that it was successful in addressing the complexities of implementing prevention programs in the real world,” Piper and colleagues comment.
They believe that “[t]he GP referral mechanism into the [Weight Watchers Diabetes Prevention Program] has the potential to have a public health impact at a population level in a relatively short period of time, if scaled up.”
But noting that the program participants were primarily female (75%) and White (90%) and only 5% were living in the most deprived areas, they say “a consideration for clinicians and policymakers is how to engage underrepresented groups such as men, [Black or ethnic minorities] and deprived communities.”
By Lucy Piper
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