Intensive Multidisciplinary Weight Management in Patients With Type 1 Diabetes and Obesity: A One-Year Retrospective Matched Cohort Study

Diabetes Obes Metab. 2019 Jan;21(1):37-42. doi: 10.1111/dom.13478. Epub 2018 Aug 30.

Abstract

Aims: Recent studies report that approximately 50% of patients with type 1 diabetes (T1D) are overweight or obese. This work studies the effects of intensive multidisciplinary weight management (IMWM) in patients with T1D and obesity.

Methods: We retrospectively evaluated 68 patients with T1D and obesity who enrolled in a 12-week IMWM program (IMWM cohort: mean age, 42 ± 11 years; HbA1c, 8.3% ± 1.0%; body weight, 104.3 ± 18.2 kg; BMI, 36.2 ± 4.9 kg/m2 ). We matched them 1:1 with a similar cohort of patients receiving standard care (SC cohort: mean age, 42 ± 12 years; HbA1c, 8.3% ± 1.0%; body weight, 102.4 ± 17.9 kg; BMI, 36.1 ± 4.7 kg/m2 ). Data were collected at baseline and at 12 months.

Results: Participants in the IMWM cohort had a body weight change of -6.6 ± 1.8 kg or -6.4% ± 1.6% of their initial body weight, while participants in the SC cohort had no change (P < 0.01 for group*time interaction). Participants in the IMWM cohort had a change in HbA1c of -0.4% ± 0.1% from baseline (P < 0.01), while participants in the SC cohort had no change. There was no difference in glycaemic control between cohorts at 12 months. Total daily insulin dose changed by -5.9 ± 1.8 units/d from baseline in the IMWM cohort while there was no change in the SC cohort (P < 0.01 for group*time interaction).

Conclusions: 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.

Keywords: lifestyle intervention; type 1 diabetes management; weight management.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Weight
  • Diabetes Mellitus, Type 1* / complications
  • Diabetes Mellitus, Type 1* / therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity* / complications
  • Obesity* / therapy
  • Retrospective Studies
  • Weight Loss
  • Weight Reduction Programs*