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Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes
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% Wh...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557466/ https://www.ncbi.nlm.nih.gov/pubmed/31245006 http://dx.doi.org/10.1136/bmjdrc-2019-000653 |
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author | Bauman, Viviana Ariel-Donges, Aviva H Gordon, Eliza L Daniels, Michael J Xu, Dandan Ross, Kathryn M Limacher, Marian C Perri, Michael G |
author_facet | Bauman, Viviana Ariel-Donges, Aviva H Gordon, Eliza L Daniels, Michael J Xu, Dandan Ross, Kathryn M Limacher, Marian C Perri, Michael G |
author_sort | Bauman, Viviana |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6557466 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65574662019-06-26 Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes Bauman, Viviana Ariel-Donges, Aviva H Gordon, Eliza L Daniels, Michael J Xu, Dandan Ross, Kathryn M Limacher, Marian C Perri, Michael G BMJ Open Diabetes Res Care Obesity Studies 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. BMJ Publishing Group 2019-05-28 /pmc/articles/PMC6557466/ /pubmed/31245006 http://dx.doi.org/10.1136/bmjdrc-2019-000653 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Obesity Studies Bauman, Viviana Ariel-Donges, Aviva H Gordon, Eliza L Daniels, Michael J Xu, Dandan Ross, Kathryn M Limacher, Marian C Perri, Michael G Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title | Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title_full | Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title_fullStr | Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title_full_unstemmed | Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title_short | Effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
title_sort | effect of dose of behavioral weight loss treatment on glycemic control in adults with prediabetes |
topic | Obesity Studies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557466/ https://www.ncbi.nlm.nih.gov/pubmed/31245006 http://dx.doi.org/10.1136/bmjdrc-2019-000653 |
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