title: Improving diabetes outcomes through lifestyle change--A randomized controlled trial.
abstract: OBJECTIVE
  To compare a diabetes group lifestyle intervention (GLI) with dietitian referral for medical nutrition therapy (RD) for weight loss in the usual care setting.
  
  
  METHODS
  Randomized clinical trial was conducted with 57 primary care patients with type 2 diabetes and body mass index (BMI) >25 kg/m(2) who received either a dietitian-led 19-week GLI adapted from the Look AHEAD study or RD. Outcome measures include 6-month and 1-year weight loss, changes in medications, glycemic control, cardiac risk factors, and cost analysis.
  
  
  RESULTS
  Patients were mean age 61, 59% male, and 32% non-white, and they weighed 97 kg with mean HbA1c 8.2%. At 6 months, 46% of GLI vs. 21% of RD lost ≥5% body weight (P = 0.04), with mean weight loss 6.6 (SD 7.0) kg with GLI and 2.1 (3.5) kg in RD (P = 0.004). HbA1c improved by 0.70 (1.13) vs. 0.39 (1.51) in GLI vs. RD (P = 0.4), respectively, and 82% vs. 38% stopped or reduced diabetes medications (P < 0.001). Weight loss remained significantly greater in GLI compared to RD at 1 year. GLI program cost was $578 per participant.
  
  
  CONCLUSIONS
  An affordable GLI achieved significantly more weight loss and medication reduction than RD in primary care patients with type 2 diabetes.
authors.affiliation: Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA.|Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Delahanty
authors.affiliation: Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Dalton
authors.affiliation: Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Porneala
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.|Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Yuchiao
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA.
authors.forename: Valerie M
authors.initials: VM
authors.lastname: Goldman
authors.affiliation: Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.|Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Levy
authors.affiliation: Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA.|Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Nathan
authors.affiliation: Department of Medicine, Massachusetts General Hospital Diabetes Center, Boston, Massachusetts, USA.|Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wexler
mesh_terms: D000368:Aged; D001294:Attitude to Health; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose