TY - JOUR
T1 - Participation in a National Lifestyle Change Program is associated with improved diabetes Control outcomes
AU - Jackson, Sandra L.
AU - Staimez, Lisa R.
AU - Safo, Sandra
AU - Long, Qi
AU - Rhee, Mary K.
AU - Cunningham, Solveig A.
AU - Olson, Darin E.
AU - Tomolo, Anne M.
AU - Ramakrishnan, Usha
AU - Narayan, Venkat K.M.
AU - Phillips, Lawrence S.
N1 - Publisher Copyright:
© 2017
PY - 2017/9
Y1 - 2017/9
N2 - Aims Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. Methods This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥ 25 kg/m2) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. Results There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! participants. Included patients were 96% male, 77% white, with mean age 58 years and BMI 34 kg/m2. Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (− 0.6 kg), random plasma glucose (− 2.8 mg/dL), and HbA1c (− 0.1%) at 12 months compared to nonparticipants (each p < 0.001). In multivariable Cox models, MOVE! participants had lower incidence of eye disease (hazard ratio 0.80, 95% CI 0.75–0.84) and renal disease (HR 0.89, 95% CI 0.86–0.92) and reduced medication intensification (HR 0.82, 95% CI 0.80–0.84). Conclusions If able to overcome participation challenges, lifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes.
AB - Aims Clinical trials show lifestyle change programs are beneficial, yet large-scale, successful translation of these programs is scarce. We investigated the association between participation in the largest U.S. lifestyle change program, MOVE!, and diabetes control outcomes. Methods This longitudinal, retrospective cohort study used Veterans Health Administration databases of patients with diabetes who participated in MOVE! between 2005 and 2012, or met eligibility criteria (BMI ≥ 25 kg/m2) but did not participate. Main outcomes were diabetic eye disease, renal disease, and medication intensification. Results There were 400,170 eligible patients with diabetes, including 87,366 (22%) MOVE! participants. Included patients were 96% male, 77% white, with mean age 58 years and BMI 34 kg/m2. Controlling for baseline measurements and age, race, sex, BMI, and antidiabetes medications, MOVE! participants had lower body weight (− 0.6 kg), random plasma glucose (− 2.8 mg/dL), and HbA1c (− 0.1%) at 12 months compared to nonparticipants (each p < 0.001). In multivariable Cox models, MOVE! participants had lower incidence of eye disease (hazard ratio 0.80, 95% CI 0.75–0.84) and renal disease (HR 0.89, 95% CI 0.86–0.92) and reduced medication intensification (HR 0.82, 95% CI 0.80–0.84). Conclusions If able to overcome participation challenges, lifestyle change programs in U.S. health systems may improve health among the growing patient population with diabetes.
KW - Diabetes complications
KW - Diabetes mellitus
KW - Veterans
KW - Weight loss
KW - Weight reduction programs
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U2 - 10.1016/j.jdiacomp.2017.06.001
DO - 10.1016/j.jdiacomp.2017.06.001
M3 - Article
C2 - 28673663
AN - SCOPUS:85021661318
SN - 1056-8727
VL - 31
SP - 1430
EP - 1436
JO - Journal of Diabetes and Its Complications
JF - Journal of Diabetes and Its Complications
IS - 9
ER -
