Intensive multidisciplinary weight management in patients with type 1 diabetes and obesity: A one‐year retrospective matched cohort study

Mottalib, Adham; Tomah, Shaheen; Hafida, Samar; Elseaidy, Taha; Kasetty, Megan; Ashrafzadeh, Sahar; Hamdy, Osama

doi:10.1111/dom.13478

Cited by 13 publications

(26 citation statements)

References 35 publications

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“…Of the 10 articles, 5 studies focused on various interventions for weight (wt.) loss, [24][25][26][27][28] while the other 5 focused on factors that impacted successful weight loss and retention in a WMP. [29][30][31][32][33] Two of the studies included primary care physicians, 25,28 but one study only included the PCP as a supportive/peripheral role in the multi-disciplinary team.…”

Section: Resultsmentioning

confidence: 99%

“…decreasing caloric intake by 500-600 kcal/day). 28,[30][31][32] Three studies by Lih et al, 24 Jennings et al, 28 and Mottalib et al 27 provided individualized diet instructions. In all the WMP studies, dietary education was given to study participants by an RD, diabetes educator or nutritionist (see Table 1), except one where a trained health coach delivered dietary education.…”

Section: Diet and Exercisementioning

confidence: 99%

“…6 Two studies followed the recommendation of structured but flexible individual activity for weight loss. 27,28 Protocols of moderate to vigorous exercise regimens were used in several studies: one study included this regimen three months after the initial gradual increase in exercise, 26 while three prescribed the increased intensity from the start of the program. 24,30,33 Although participants were instructed/educated about need for exercise, two studies did not specify instructions or education for participants.…”

Section: Diet and Exercisementioning

confidence: 99%

“…31 Most of the WMPs gave exercise instructions, regarding number of minutes per week and intensity consistent with AMSSM recommendations for weight loss. 24,[26][27][28]30,33 In addition to diet and exercise, two studies used medications to assist with weight loss 27,28 Orlistat is a standard weight loss medication with a good safety profile that was used in the study by Jennings et al 28 The investigators in a study of patients with type 1 DM and obesity adjusted medications that were obesogenic (e.g. switching longterm insulin to detemir, degludec, or glargine that induce less weight gain), as well as added metformin and pramlintide which demonstrate the side effect profiles favorable for weight loss.…”

Section: Diet and Exercisementioning

confidence: 99%

“…In addition, all studies included accountability for whether participants attended individual or group visits as means to increase weight loss success. Many of the studies utilized group visits as intervention or vehicle for care delivery, 24,25,27,28,30,31,52 as group visits have been shown to enhance outcomes in patients with chronic diseases like diabetes, congestive heart failure (CHF), and obesity. [53][54][55] Assessment of participants' behavioral health status via standardized screenings/assessment tools or behavioral health providers, is common in studies with 24,28,[30][31][32][33] or without 25,26 formal assessment or treatment of behavioral health factors.…”

Section: Behavioral Therapiesmentioning

confidence: 99%

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Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

Bright

O’Hare

Beesley

et al. 2019

Exp Biol Med (Maywood)

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Obesity is a costly and complex health issue that precipitates and/or complicates many medical conditions. Clinical recommendations include a comprehensive approach to weight loss with a combination of diet, physical activity, behavioral interventions, pharmacotherapy or surgery to achieve weight loss. Care in the primary care setting is integral in obesity management. Outside of their clinical role, primary care physicians serve as role models, educators, and promoters of healthy lifestyle practices and leaders in obesity treatment. Physician recommendations have consistently been shown to exert a powerful influence on patient behavior, but there is a substantial gap between patients who would benefit from obesity care and those receiving it. Providers, especially primary care, cite many obstacles to addressing obesity including lack of time, expertise, and resources. This review focuses on describing the feasibility and evidence for tackling obesity through provider-led multidisciplinary weight management programs. A literature search was conducted in Med Line and PubMed for published articles on multidisciplinary weight management programs that included lifestyle modification (diet and exercise), behavioral modification and a physician (MD/DO) with one or more of the following multidisciplinary team members: nutritionist/registered dietician (RD), behavioral health provider (BH), case manager (CM), pharmacist (Pharm), nursing (RN), and research staff. Relevant articles from bibliographies of systematic reviews/meta-analyses were included as well. Ten studies qualified, and we organized the articles to discuss the following three themes: diet and exercise, behavioral therapies and barriers, and facilitators for clinical weight management programs. The studies in this mini-review of multidisciplinary weight programs that included physicians reiterate the guidelines for successful treatment of obesity, with more research needed to fully understand how primary care providers can assist higher risk patient populations, particularly those of lower socioeconomic status who are disproportionally impacted by obesity.

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Section: Resultsmentioning

confidence: 99%

Section: Diet and Exercisementioning

confidence: 99%

Section: Diet and Exercisementioning

confidence: 99%

Section: Diet and Exercisementioning

confidence: 99%

Section: Behavioral Therapiesmentioning

confidence: 99%

See 3 more Smart Citations

Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

Bright

O’Hare

Beesley

et al. 2019

Exp Biol Med (Maywood)

View full text Add to dashboard Cite

show abstract

Clinical potential of fasting in type 1 diabetes

Varady,

Runchey,

Reutrakul

et al. 2024

Trends in Endocrinology & Metabolism

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Treating obesity in type 1 diabetes mellitus – review of efficacy and safety

Freeby,

Lane

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review Obesity is an epidemic in the United States with serious concomitant co-morbid conditions; people living with type 1 diabetes mellitus (T1D) are not immune to the risk either. Weight gain in T1D is likely multifactorial, due to genetic, environmental and treatment-related factors. FDA-approved and other adjunctive weight loss therapies may benefit people living with T1D but there are risks to consider when providing recommendations or prescribing medications. Recent findings We performed a PubMed search of studies assessing clinical outcomes of both approved and off-label medications used in the treatment of type 1 diabetes. Search terms included ‘type 1 diabetes, obesity’ and the following: (1) metformin, (2) pramlintide, (3) glucagon-like peptide-1 (GLP-1) receptor agonists, (4) dual GLP-1 and gastric inhibitory polypeptide (GIP) agonists, (5) sodium-glucose cotransporter-2 (SGLT-2) inhibitors, (6) surgical treatment of obesity, (7) insulin pump, (8) insulin, (9) medical nutrition therapy, (10) diabetes self-management education, (11) exercise, (12) naltrexone-buproprion, (13) orlistat, and (14) phentermine-topiramate. Summary Weight loss treatments provide a wide-range of benefits in reducing both morbidity and mortality in those who are obese. Treatments also have varying adverse effect profiles which may impact T1D treatment. In this review, we aim to summarize study outcomes in people with T1D, including risks and benefits, of on- and off-label weight loss treatments.

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Intensive multidisciplinary weight management in patients with type 1 diabetes and obesity: A one‐year retrospective matched cohort study

Abstract: In comparison to standard care, patients with T1D and obesity who participated in an IMWM programme achieved significant weight loss and significant reduction in daily insulin dose at 1 year. Weight reduction was associated with improvements in glycaemic control compared to baseline.

Cited by 13 publications

References 35 publications

Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

Tipping the scales: Provider perspectives on a multi-disciplinary approach to obesity

Clinical potential of fasting in type 1 diabetes

Treating obesity in type 1 diabetes mellitus – review of efficacy and safety

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