Why WAIT Program: A Novel Model for Diabetes Weight Management in Routine Clinical Practice

Hamdy, Osama; Goebel-Fabbri, Ann; Carver, Catherine; Arathuzik, Gillian; Shahar, Jacqueline; Capelson, Roberta; Beaton, Joan; O’Donnell, Stacey; ElSayed, Nuha A.; Mitri, Joanna; Mentzelopoulos, Voula; Abrahamson, Martin J.

doi:10.1089/obe.2008.0206

Cited by 15 publications

(11 citation statements)

References 18 publications

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“…Very low calorie diet as total meal replacement (TMR) undoubtedly improves weight loss and glycemic control (1) but is difficult to maintain. Partial meal replacement (PMR) as part of an overall treatment strategy has been shown to be beneficial (2)(3)(4) and to an extent proportional to the number of meal replacements used over a period of several years (5). What is not known is whether advising patients to have PMR for one or two meals is more effective in the longer term.…”

Section: Introductionmentioning

confidence: 99%

How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes

Leader

Ryan

Molyneaux

et al. 2013

Obesity

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Objective: To compare patient compliance and benefits, over 12 months, of 1 versus 2 partial meal replacement (PMR) for the management of overweight/obese subjects with inadequately controlled type 2 diabetes. Design and Methods: Thirty-six overweight patients with inadequately controlled type 2 diabetes (BMI > 27 kg/m 2 and HbA1c > 7.5% [58 mmol/mol]) were randomized to receive 1 or 2 PMR/day, while maintaining usual lifestyle. Subjects were seen monthly and adjustment of medications was made to prevent hypoglycemia. Compliance was assessed by counting unused sachets. Results: Patients on 2 PMR/day lost almost 4 kg compared with only 0.5 kg in the 1 PMR/day group. This difference was statistically significant (P < 0.05). Overall PMR was about 30% as effective as in our previous study on total meal replacement. Reductions in weight, waist, and HbA1c were better in the 2 PMR/day group while patient dropout and compliance were not worse over a 12-month period.Conclusion: PMR provides a further management option for overweight/obese individuals with type 2 diabetes. The initial recommendation should be 2 PMR/day.

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Section: Introductionmentioning

confidence: 99%

How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes

Leader

Ryan

Molyneaux

et al. 2013

Obesity

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“…For example, the decision was made to separate the TLP from standard diabetes education and medical management received by the participants to maintain differences between the treatment arms. In clinical practice, integrating family-based weight-loss programs into existing diabetes care could be more beneficial to patients 66. Further, given the diverse family constellations of TODAY participants, an effort was made to enhance the feasibility and acceptability of the TLP by not requiring (although supporting if requested) the identified FSP to engage in his or her own weight-loss efforts, despite extant research evidence indicating that parental weight loss is related to successful weight loss in children 49.…”

Section: Implications and Future Directionsmentioning

confidence: 99%

Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study

Nwosu¹

2009

Int J Obes

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Type 2 diabetes is associated with obesity and is increasing at an alarming rate in youth. Although weight loss through lifestyle change is one of the primary treatment recommendations for adults with type 2 diabetes, the efficacy of this approach has not been tested with youth. This paper provides a summary of the reviews and meta-analyses of pediatric weight-loss interventions that informed the design and implementation of an intensive, family-based lifestyle weight management program for adolescents with type 2 diabetes and their families developed for the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study. A total of 1092 youth have been screened, and 704 families have been randomized for inclusion in this 15-center clinical trial sponsored by the National Institutes of Health. The TODAY study is designed to test three approaches (metformin, metformin plus rosiglitazone and metformin plus an intensive lifestyle intervention) to the treatment of a diverse cohort of youth, 10-17 years of age, within 2 years of their diagnosis. The principal goal of the TODAY Lifestyle Program (TLP) is to decrease baseline weight of youth by 7-10% (or the equivalent for children who are growing in height) through changes in eating and physical activity habits, and to sustain these changes through ongoing treatment contact. The TLP is implemented by interventionists called Personal Activity and Nutrition Leaders (PALs) and delivered to youth with type 2 diabetes, and at least one family support person. The TLP provides a model for taking a comprehensive, continuous care approach to the treatment of severe overweight in youth with comorbid medical conditions such as type 2 diabetes.

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“…Через 12 мес наблюдения пациенты группы вмешательства потеряли 5,8% исходного веса, вес пациентов контрольной группы уменьшился на 1,2%; при этом снижение МТ на 5% и более было отмечено у половины пациентов группы вмешательства и в 6,5 раза больше был шанс достижения этого результата по сравнению с контролем; помимо этого, около четверти пациентов снизили МТ на 10% и более. В оригинальном исследовании Why WAIT были продемонстрированы следующие результаты: за 3 мес вес пациентов снижался в среднем на 9,8%±0,4% и поддерживался примерно на этом уровне в ходе наблюдения [21]. Однако следует учитывать, что в исследовании Why WAIT при сопоставимом распределении участников по полу исходный вес пациентов был больше и составлял 107,5 кг, в то время как в исследовании «Жизнь легка» средний вес пациентов составлял 95,1 кг.…”

Section: Discussionunclassified

Multidisciplinary lifestyle management approach in patients with type 2 diabetes mellitus in real clinical practice. Results of application “Life is easy” programme in Russia

et al. 2019

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BACKGROUND: Type 2 diabetes mellitus (T2DM) is a disease with high medical and social impact due to its wide and ever-increasing prevalence, high hospitalization and mortality rates. Despite the whole range of therapeutic options, lifestyle intervention remains as important as ever since it underlies guidelines of T2DM management. AIMS: To evaluate the effect of intensive lifestyle management approach on body weight reduction and on long-term maintenance of the achieved results in patients with T2DM. MATERIALS AND METHODS: We performed multicenter, interventional, prospective, non-randomized 12 month study. One hundred thirty overweight (obese) patients with T2DM included in the study were divided into two groups: group of lifestyle intervention (n=100) and control group (n=30). Patients in the group of lifestyle intervention participated in the intensive lifestyle modification and body weight reduction programme, which consisted of components: change in diet plan, physical exercise programme, cognitive behavioral techniques, educational and medical support. Clinical assessment and completing of patient questionnaires were performed at baseline, after 3 and 12 months. Patients in the control group did not attend programme, their clinical data were recorded during clinical visits every 3 months. RESULTS: Ninety patients (90%) in the group of lifestyle intervention and twenty nine patients (96.7%) in the control group completed the study and fulfilled protocol. After 12 months, patients in the group of lifestyle intervention lost 5.8% of their baseline weight and patients in the control group showed 1.2% decrease of their baseline weight. Body weight loss 5% was observed in 49.2% of patients in the group of lifestyle intervention and in 12.9% of patients in the control group (OR=6.54 [2.01; 21.33]; р=0.002). By the end of observation, delta reduction of glycated hemoglobin (HbA1c) in the intervention group was higher than in the control group (0.79% and 0.11%, respectively), the odds ratio for lowering HbA1c 0.5% from baseline between two groups was 14.10 [3.24; 61.30] (p0.001) in favor of the group of lifestyle intervention. 58.3% patients in the group of lifestyle intervention with baseline level of HbA1c 7% (n=48) achieved a HbA1c target of 7%; in the control group two patients (13.3%) out of fifteen with baseline level of HbA1c 7% achieved the target after 3 months and returned to baseline by the end of observation. CONCLUSIONS: Our results suggest that the programme of intensive lifestyle modification in patients with T2DM is highly efficient and safe.

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Why WAIT Program: A Novel Model for Diabetes Weight Management in Routine Clinical Practice

Cited by 15 publications

References 18 publications

How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes

How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes

Design of a family-based lifestyle intervention for youth with type 2 diabetes: the TODAY study

Multidisciplinary lifestyle management approach in patients with type 2 diabetes mellitus in real clinical practice. Results of application “Life is easy” programme in Russia

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