Journal
DIABETES CARE
Volume 37, Issue 8, Pages 2177-2185Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc13-2427
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Funding
- National Health and Medical Research Council (NHMRC)
- Australian Diabetes Society National Diabetes Strategy Grant
- NHMRC [569861]
- Queensland Health
- Australian Research Council Future Fellowship
- Heart Foundation Postdoctoral Fellowship [PH 12B 7054]
- National Breast Cancer Foundation
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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 HbA(1c) 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 inweight 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 HbA(1c) 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.
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