Intensive lifestyle intervention decreases HbA1c in blacks with type 2 diabetes
NEW ORLEANS — An intensive lifestyle intervention program aimed at lowering blood glucose in low-income blacks with type 2 diabetes was successful in reducing HbA1c after 6 months, according to a presenter here.
However, at the end of 1 year, there was no significant difference between those who underwent the intensive lifestyle intervention and those receiving standard-of-care education, according to Elizabeth B. Lynch, PhD, associate professor in the department of preventive medicine at Rush University Medical Center in Chicago.
“Sustained behavior change is very difficult and may be especially difficult for low-income, high-risk patients with type 2 diabetes,” Lynch said. “While our results confirm positive results in a high-risk population with intensive educational and social support, they also suggest that, over time, motivated patients take the initiative and achieve glycemic control with standard-of-care education.”
Lynch and colleagues evaluated 211 low-income black patients (mean age, 55 years; 70% women; income, $20,000 per year; BMI, 35.6 kg/m2; diabetes duration, 11.3 years) with uncontrolled type 2 diabetes attending five outpatient clinics in the Cook County Health and Hospitals System known as the Lifestyle Improvement through Food and Exercise program (LIFE; n = 106) or a control group that received standard-of-care education (n = 105).
The intervention group was offered 28 counseling sessions with dieticians and peer supporters during 1 year, meeting weekly for the first 4 months, biweekly for the second 4 months and monthly for the last 4 months. They also received weekly phone calls from peer supporters during the study period. The control group received two diabetes self-management education group classes led by a registered dietician during the first 6 months of the study.
At 6 months, there was a significantly greater reduction in HbA1c in the intervention group (-0.76%) compared with the control group (-0.21%; P = .026); this was no longer true at 12 months (intervention, -0.63% vs. control, -0.45; P = .47). At 6 months, the proportion of participants with an HbA1c reduction of 0.5% was greater in the intervention group (63%) compared with controls (42%; P = .005); however, it did not remain at 12 months.
“One possible explanation for the decrease in HbA1c in the control group is that medication adherence increased in this group, relative to the intervention group,” Lynch said. “Additional research is needed to identify the most effective strategies to achieve sustained HbA1c control in African Americans with type 2 diabetes.” – by Amber Cox
Lynch EB, et al. 282-OR. Presented at: American Diabetes Association’s Scientific Sessions; June 10-14, 2016; New Orleans.
Disclosure: The researchers report no relevant financial disclosures.