title: A novel multidisciplinary intervention for long-term weight loss and glycaemic control in obese patients with diabetes.
abstract: BACKGROUND
  Obesity and diabetes are difficult to treat in public clinics. We sought to determine the effectiveness of the Metabolic Rehabilitation Program (MRP) in achieving long-term weight loss and improving glycaemic control versus "best practice" diabetes clinic (DC) in obese patients using a retrospective cohort study.
  
  
  METHODS
  Patients with diabetes and BMI > 30 kg/m(2) who attended the MRP, which consisted of supervised exercise and intense allied health integration, or the DC were selected. Primary outcomes were improvements in weight and glycaemia with secondary outcomes of improvements in blood pressure and lipid profile at 12 and 30 months.
  
  
  RESULTS
  Baseline characteristics of both cohorts (40 MRP and 40 DC patients) were similar at baseline other than age (63 in MRP versus 68 years in DC, P = 0.002). At 12 months, MRP patients lost 7.65 ± 1.74 kg versus 1.76 ± 2.60 kg in the DC group (P < 0.0001) and 9.70 ± 2.13 kg versus 0.98 ± 2.65 kg at 30 months (P < 0.0001). Similarly, MRP patients had significant absolute reductions in %HbA1c at 30 months versus the DC group (-0.86 ± 0.31% versus 0.12% ± 0.33%, P < 0.038), with nonsignificant improvements in lipids and blood pressure in MRP patients.
  
  
  CONCLUSIONS
  Further research is needed to establish the MRP as an effective strategy for achieving sustained weight loss and improving glycaemic control in obese patients with type 2 diabetes.
authors.affiliation: Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Rhodes, NSW 2139, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Lih
authors.affiliation: Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Rhodes, NSW 2139, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Pereira
authors.affiliation: Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Rhodes, NSW 2139, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Ramy H
authors.initials: RH
authors.lastname: Bishay
authors.affiliation: Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Rhodes, NSW 2139, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Johnson
authors.initials: J
authors.lastname: Zang
authors.affiliation: University of New South Wales Medical Program, University of New South Wales, Sydney, NSW 2052, Australia ; Department of Vascular Medicine, St. Vincent's Hospital, Darlinghurst, Sydney, NSW 2010, Australia.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Omari
authors.affiliation: School of Nursing and Midwifery, University of Western Sydney, Campbelltown, NSW 2560, Australia ; School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia.
authors.forename: Evan
authors.identifier: 0000-0001-5877-6141
authors.initials: E
authors.lastname: Atlantis
authors.affiliation: Department of Endocrinology & Metabolism, Concord Repatriation General Hospital, Rhodes, NSW 2139, Australia ; Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
authors.forename: Nic
authors.initials: N
authors.lastname: Kormas
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000628:therapy*; D004038:Diet, Reducing; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D008055:Lipids