CLINICAL OUTCOMES IN PATIENTS WITH DIABETES MELLITUS USING A MEDICALLY SUPERVISED COMMERCIAL WEIGHT REDUCTION PROGRAM COMPARED TO STANDARD CARE IN AN ENDOCRINE SPECIALTY CLINIC

Aims: To evaluate metabolic and anthropometric changes achieved and maintained by diabetic patients (pts) in a structured weight loss (WL) program vs. usual care in an endocrine clinic (UCG). Materials and Methods: This retrospective comparison study examined 38 diabetic pts with BMI >25 undergoing the active weight loss phase of WL determined by patient goal weight and then followed for 6 months in weight maintenance phase (WM). Multiple endpoints were assessed at baseline including BMI and hemoglobin A1c (A1c). Endpoints were reassessed at 6 months in WM. The usual care group (UCG) was obtained through chart review of 26 diabetic pts with BMI > 25 in an endocrine specialty clinic who completed an education program including lifestyle counseling by a certified diabetic educator. Data were analyzed using ANCOVA and protected LSD, adjusting for age, gender, and baseline weight. Results: Patients showed a change in BMI at 6 months of -6.8 ± 0 (bsl 44 ± 8.4) and -0.7 ± 1.1 (bsl 35 ± 6.2) for HMR® pts and UCG, respectively (p < 0.05). HMR® pts had 13.4% ± 3 % WL vs 7.9% ± 4% in UCG p = 0.34). 6 month A1c was similar in HMR pts (7.5% ± 2; bsl 8.3 ± 1.9) and UCG (7.5% ± 2.3; bsl 9.8 ± 1.8). HMR® pts had a reduction of total medication usage of 28%, with at least one medication discontinued in 80% of pts, while the UCG had only 23% of pts with discontinuation of at least one medication (p < 0.05). Conclusions: Compared to CDE-led diabetic education emphasizing lifestyle change, pts in an intensive WL program utilizing weekly coaching, meal replacements, and exercise, had a significant decrease in BMI and achieved a similar A1c with reduction in medication requirements.