Long-term follow-up of a randomized clinical trial comparing glycemic excursion minimization (GEM) to weight loss (WL) in the management of type 2 diabetes
| Autor: | Anthony L. McCall, Mark R. Conaway, Matthew Moncrief, Tamara K. Oser, Daniel J. Cox |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Research design
Adult Blood Glucose medicine.medical_specialty endocrine system diseases Endocrinology Diabetes and Metabolism Type 2 diabetes Diseases of the endocrine glands. Clinical endocrinology law.invention Randomized controlled trial Weight loss law Diabetes mellitus Internal medicine Weight Loss Medicine Humans Glycemic Aged Aged 80 and over business.industry Blood Glucose Self-Monitoring life style Middle Aged medicine.disease RC648-665 Regimen Diabetes Mellitus Type 2 type 2 diabetes mellitus glycated hemoglobin A Clinical care/Education/Nutrition hyperglycemia medicine.symptom business Body mass index Follow-Up Studies |
| Zdroj: | BMJ Open Diabetes Research & Care, Vol 9, Iss 2 (2021) BMJ Open Diabetes Research & Care |
| ISSN: | 2052-4897 0319-6895 |
| Popis: | IntroductionWe previously reported the physical, psychological and behavioral 3-month post-treatment results of a randomized controlled trial comparing glycemic excursion minimization (GEM) versus conventional weight loss (WL) therapy in the management of type 2 diabetes (T2D). GEM is a paradigm shift in the lifestyle management of T2D that focuses on reducing postnutrient glucose excursions, rather than reducing weight. We now present the 13-month follow-up results.Research design and methodsThe initial study sample of 172 were 30–80 years old, had T2D for ≤10 years, an HbA1c ≥6.8% (51 mmol/mol), and were not using insulin. Participants were randomized to 6 hours of group treatment, either to WL or one of three versions of GEM. GEM groups differed in degree of blood glucose (BG) feedback provided during treatment: no recommended feedback, systematic capillary BG feedback before and after nutrient intake and physical activity, or continuous glucose monitoring. Since these GEM groups did not differ in pre-post improvement they were combined for initial and current analyses. Of those who completed the 3-month postassessment, 100% and 96% of the WL and GEM participants completed the 13-month follow-up assessment.ResultsPre to follow-up within-group comparisons indicated WL participants sustained improvement in body mass index (BMI) (−0.9±1.4, p=0.001). GEM participants continued to benefit in their HbA1c (−0.5±1.4, pConclusionsWhile WL sustained improvement in BMI, GEM sustained benefits across a broad range of physical, behavioral and psychological parameters, beneficial for clinicians and adults with T2D. This may be especially relevant for primary care physicians who manage about 90% of patients with T2D.Trial registration numberNCT03196895. |
| Databáze: | OpenAIRE |
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