Are behavioural approaches feasible and effective in the treatment of type 2 diabetes? A propensity score analysis vs. prescriptive diet

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
G ForlaniG Marchesini

Abstract

Lifestyle changes are considered first line treatment in type 2 diabetes, but very few data are available in the "real world" of diabetes units. We aimed to measure the effectiveness of moderate and high intensity interventions on weight loss, metabolic control and insulin use. We report a prospective cohort study, carried out in 822 consecutive subjects with type 2 diabetes, first seen in a 4-year period in a diabetes unit of an academy hospital. Subjects were treated with either a sole prescriptive diet (Diet), or received an additional short-course Elementary Nutritional Education (4 group sessions-ENE) or an intensive Cognitive Behavioural Therapy (12-15 group sessions-CBT). The results were adjusted for the propensity score to be assigned different treatments, derived from logistic regression on the basis of age, gender, BMI, HbA1c, diabetes duration and insulin use at baseline. Main outcome measures were weight loss and weight loss maintenance, metabolic control, and secondary failure to insulin use. Both structured programmes produced a larger weight loss, and the adjusted probability of achieving the 7% weight loss target was increased. Similarly, both programmes favoured metabolic control, irrespective of insulin use. ...Continue Reading

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Citations

Sep 2, 2011·Journal of the American Veterinary Medical Association·Debra L Zoran, C A Tony Buffington
Sep 21, 2010·QJM : Monthly Journal of the Association of Physicians·L ValentiG Marchesini
Jul 18, 2016·Internal and Emergency Medicine·Paolo MazzucaGiulio Marchesini
Mar 8, 2011·Clinics and Research in Hepatology and Gastroenterology·Serge Erlinger
Jun 23, 2020·Health Technology Assessment : HTA·Kirsty WinkleyKhalida Ismail

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