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Assessment of a Multidisciplinary Intervention in Patients With BMI ≥35 kg/m2 and Recently Diagnosed Type 2 Diabetes.

A. C. García-Ulloa,Victoria Landa-Anell,M. Melgarejo-Hernández,Andrea Villegas-Narváez,L. E. Urbina-Arronte,S. Hernández-Jiménez

Published 2019 in Journal of Clinical Endocrinology and Metabolism

ABSTRACT

CONTEXT Patients with a body mass index (BMI) ≥35 kg/m2 have lower benefits with intensive treatments and metabolic control goals are more difficult to reach. OBJECTIVE Evaluate the effect of a comprehensive care program in patients with a BMI ≥35 kg/m2. DESIGN Prospective cohort study. SETTING Comprehensive Care Center in a National Institute of Health. PATIENTS Patients with type 2 diabetes, ≤5 years of diagnosis, without disabling complications, nonsmokers, and a BMI <45 kg/m2. INTERVENTIONS Exercise and nutritional interventions are modified for patients with a higher BMI to achieve metabolic control. MAIN OUTCOME MEASURES Main outcome is achievement of treatment goals defined as HbA1c <7%, low-density lipoprotein cholesterol (LDL-c) <100 mg/dL, and blood pressure <130/80 mm Hg. Secondary measures were the percentage of patients achieving three metabolic goals. RESULTS A total of 587 patients with annual evaluation were included. Mean age was 55.3 ± 9.5 years, 56.6% women, time since diagnosis of 1 year (0 to 5). BMI <35 kg/m2 group included 521 patients and BMI ≥35 kg/m2 group included 66 patients. In the BMI ≥35 kg/m2 group, we observed a greater decrease in weight and fat mass at 3 months compared with <35 kg/m2 group, but the HbA1c, LDL-c, or blood pressure goals were similar at 3 months and 1 year between groups. CONCLUSIONS Comprehensive interventions are equally effective in patients with recently diagnosed type 2 diabetes with BMI ≥35 kg/m2 compared with patients with a lower BMI.

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