Living well with diabetes: 24-month outcomes from a randomized trial of telephone-delivered weight loss and physical activity intervention to improve glycemic control

Eakin, Elizabeth, Winkler, Elisabeth, Dunstan, David, Healy, Genevieve, Owen, Neville, Marshall, Alison, Graves, Nicholas, & Reeves, Marina (2014) Living well with diabetes: 24-month outcomes from a randomized trial of telephone-delivered weight loss and physical activity intervention to improve glycemic control. Diabetes Care, 37(8), pp. 2177-2185.

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Abstract

OBJECTIVE:

To evaluate the effectiveness of a telephone-delivered behavioral weight loss and physical activity intervention targeting Australian primary care patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS:

Pragmatic randomized controlled trial of telephone counseling (n = 151) versus usual care (n = 151). Reported here are 18-month (end-of-intervention) and 24-month (maintenance) primary outcomes of weight, moderate-to-vigorous-intensity physical activity (MVPA; via accelerometer), and HbA1c level. Secondary outcomes include dietary energy intake and diet quality, waist circumference, lipid levels, and blood pressure. Data were analyzed via adjusted linear mixed models with multiple imputation of missing data.

RESULTS:

Relative to usual-care participants, telephone counseling participants achieved modest, but significant, improvements in weight loss (relative rate [RR] -1.42% of baseline body weight [95% CI -2.54 to -0.30% of baseline body weight]), MVPA (RR 1.42 [95% CI 1.06-1.90]), diet quality (2.72 [95% CI 0.55-4.89]), and waist circumference (-1.84 cm [95% CI -3.16 to -0.51 cm]), but not in HbA1c level (RR 0.99 [95% CI 0.96-1.02]), or other cardio-metabolic markers. None of the outcomes showed a significant change/deterioration over the maintenance period. However, only the intervention effect for MVPA remained statistically significant at 24 months.

CONCLUSIONS:

The modest improvements in weight loss and behavior change, but the lack of changes in cardio-metabolic markers, may limit the utility, scalability, and sustainability of such an approach.

Impact and interest:

10 citations in Scopus
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8 citations in Web of Science®

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ID Code: 88661
Item Type: Journal Article
Refereed: Yes
DOI: 10.2337/dc13-2427
ISSN: 0149-5992
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: © 2014 by the American Diabetes Association
Copyright Statement: Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
Deposited On: 03 Nov 2015 00:48
Last Modified: 03 Nov 2015 00:48

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