Effect of a group medical clinic for veterans with diabetes on body mass index

被引:2
|
作者
Eisenberg, Adva [1 ]
Crowley, Matthew J. [1 ,2 ]
Coffman, Cynthia [2 ,3 ]
Edelman, David [1 ,2 ]
机构
[1] Duke Univ, Med Ctr, Dept Med, Durham, NC 27710 USA
[2] Durham VA Med Ctr, Hlth Serv Res & Dev Serv, Durham, NC USA
[3] Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC USA
关键词
Body mass index; diabetes; group medical clinic; veterans; weight loss; LOW-CARBOHYDRATE DIETS; WEIGHT-LOSS PROGRAMS; HEALTH; MANAGEMENT; OBESITY; RISK; CARE; METAANALYSIS; OUTCOMES; IMPACT;
D O I
10.1177/1742395317753885
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective To assess the impact of a group medical clinic designed for patient with type 2 diabetes mellitus and hypertension on body mass index. Methods Using data from a randomized trial of 239 veterans with type 2 diabetes mellitus, we performed a secondary analysis using analysis of covariance mixed models to explore the effect of a 12-month group medical clinic intervention on change in body mass index vs. usual care. In an exploratory subgroup analysis, we compared change in body mass index between treatment arms stratified by whether patients had >0.5% reduction in hemoglobin A1c at 12 months. Results Baseline body mass index was 33.5 kg/m(2). At 12 months, there was no significant difference in change in body mass index between treatment arms (estimate=-0.02, 95% CI -0.51 to 5.05; P = 0.94); body mass index increased by approximately 0.20 points in both groups. There was also no significant difference in change in body mass index between treatment arms by whether or not patients had >0.5% reduction in hemoglobin A1c (estimate=-0.14, 95% CI -1.21 to -0.92; P = 0.79). Discussion Improved glycemic control was not associated with improved body mass index in the group medical clinic intervention. Given their positive effects on other outcomes, group medical clinics for patients with type 2 diabetes mellitus may be more beneficial if focus is shifted towards weight loss.
引用
收藏
页码:187 / 196
页数:10
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