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Malay| Session: | New Findings from Controlled Behavioral Interventions |
| Abstract Number: | 1-OR |
| Title: | Impact of Weight Loss on Patient-Reported Outcomes in Obese Type 2 Diabetes |
| Presentation Start: | 6/21/2013 4:15:00 PM |
| Presentation End: | 6/21/2013 4:30:00 PM |
| Authors: | DONALD C. SIMONSON, ANN GOEBEL-FABBRI, FLORENCIA HALPERIN, OSAMA HAMDY, ASHLEY VERNON, MARLENE WEWALKA, SU-ANN DING, KERRI CLANCY, KATHLEEN FOSTER, JENNIFER PANOSIAN, DAVID B. LAUTZ, ALLISON B. GOLDFINE, Boston, MA. |
| Abstract: | To assess effects of weight loss on patient-reported outcomes, we randomized 39 obese T2D (15M/24F; weight 103±16 kg; BMI 36.1±3.5 kg/m²; age 51±6 yrs; HbA1c 8.5±1.3%; 62% on insulin) to intensive medical diabetes and weight management (IMWM; n=20) or laparoscopic Roux-en-Y gastric bypass (RYGB; n=19). At baseline subjects exhibited modestly low SF-36 physical (PH) (62±17) and mental (MH) health (62±15), and high Impact of Weight on Quality of Life (IWQOL) (74±23) and Problem Areas in Diabetes (PAID) (54±14) health status scores. At 10% weight loss or 3 mo if 10% loss not achieved, RYGB realized greater weight loss (-11.6±0.9 vs -7.2±0.8 kg; P<0.001), but HbA1c decline was similar (-1.5±0.3 vs -1.7±0.2%). SF-36 PH improved more in IMWM vs RYGB (10±2 vs 0±4; P=0.02), with trend toward greater increase in SF-36 MH (12±3 vs 6±4). Reductions in IWQOL (-14±3 vs -14±3) and PAID (-6±3 vs -12±3) were similar between groups. At 1 year, RYGB had greater weight loss (-25±2 vs -7±2 kg; P<0.0001) and sustained improved HbA1c (-1.6±0.3 vs -0.2±0.5%; P=0.02) vs IMWM. Improvements in SF-36 PH (8±2 vs 10±4) and MH (10±2 vs 10±4) and PAID (-15±3 vs -19±4) did not differ between groups. However, IWQOL improved more in RYGB (-34±6 vs -12±5; P<0.01), and correlated with greater weight loss (r = 0.55, P<0.01). Thus, in obese T2D, 1) RYGB produces greater weight loss and sustained improvements in HbA1c compared to medical management, 2) both treatments improve general physical and mental health, and reduce problems associated with diabetes management, and 3) RYGB provides greater improvement in QOL specifically associated with obesity. These differences may inform therapeutic decisions for weight loss strategies in obese T2D. |
Speaker: Donald C Simonson Meeting: 73rd Scientific Sessions (2013)
Session: New Findings from Controlled Behavioral Interventions
