For people with difficult-to-control diabetes, adding intensive weight management counseling to group medical visits provided extra health benefits beyond improved blood-sugar control, according to a new study.
The weight counseling approach emphasized a low-carb diet, with participants logging better weight loss, less use of diabetes medications, and fewer potentially dangerous episodes of plummeting blood sugar levels compared to study participants who only attended group diabetes sessions.
“Group medical visits are an increasingly popular way to care for diabetes patients,” says lead author William Yancy, director of the Diet & Fitness Center at Duke University and research associate at the Durham VA Medical Center. “This approach can be efficient for patients who share a common chronic condition, enabling them to receive education, self-management skills training, and medication management to improve clinical outcomes.
Yancy and colleagues enrolled 263 people with uncontrolled diabetes and followed them over the one-year study.
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The researchers randomly assigned half of the participants to participate in group medical visits monthly for four months to learn how to manage their diabetes. They assigned the other half to group medical visits that included intensive diet coaching aimed at keeping them on a low-carbohydrate regimen. This group met every two weeks for four months.
After the first four months, both groups met every eight weeks until the study ended.
Initially, participants who had the diet intervention showed marked improvement in blood glucose control compared to those in the other group, but by the end of the study, those differences evened out and both interventions proved similarly helpful in lowering glucose levels.
However, the addition of weight management counseling provided extra health benefits, including weight loss and a 50% reduction in incidents of hypoglycemia. What’s more, diabetes medication use declined for participants in the weight management group while it rose in the other group.
“Intensive weight management using a low-carbohydrate diet can be as effective for glycemic improvement as medication intensification,” Yancy says. “We know that lifestyle changes can be difficult to maintain, but this study shows that group meetings can be an efficient and effective strategy that helps patients sustain these improvements.”
The findings appear in JAMA Internal Medicine.
About the Author
Lead author William Yancy, director of the Diet & Fitness Center at Duke University and research associate at the Durham VA Medical Center.
Support for the study came from the Department of Veterans Affairs, the Durham Center of Innovation to Accelerate Discovery and Practice Transformation at the Durham Veterans Administration Health Care System, Veterans Affairs Health Services Research and Development, and the National Institutes of Health.
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