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Assessment of Weight Loss in the Management of Patients with Type 2 Diabetes Mellitus in Primary Care in Trinidad

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Author(s): Dr. Kameel Mungrue

Journal: Journal of Diabetes & Metabolism
ISSN 2155-6156

Volume: 2;
Issue: 20;
Date: 2011;
Original page

ABSTRACT
Objectives: To determine the proportion of patients with Type 2 diabetes mellitus (T2DM) who lost 5-10% of their body weight as part of their initial management. To determine associations between metformin use, advice on dietary and physical modification on weight loss. Design and method: A retrospective observational study was performed with a total of 647 adults age range 71years (92-21) with T2DM, identified from the diabetic registry at El Socorro health center. Adults with BMI>25, demographics, initial weight on joining clinic and weight 12-18 months after attending clinic, lifestyle changes and metformin use were recorded. Data was analyzed using SPSS version 15. Multiple linear regression was used to determine predictors of weight loss. Additionally, any relationships between variables and weight loss were highlighted using the Pearson’s correlation. Results: 410(63.4%) of the 647 participants met the criteria for entry into the study which meant that at entry 63.4% of patients with T2DM were overweight or obese. Further 206(50.2%) participants gained weight, 196(47.8%) lost weight and 8(2%) had no change. The 196 participants who lost weight had a mean weight loss of 3.9kgs of which only 62 (15 %) achieved at least 5% weight loss. The use of both lifestyles interventions and metformin produced the largest weight reduction (11.8Kgm), which supports the ADA recommendation as the current method of initiating treatment in the patient with T2DM. Conclusion: Only 15% of adults lost at least 5% of their initial weight according to ADA recommendations. With 51% of adults gaining weight it is recommended that more emphasis should be placed on weight loss as part of initial management of diabetes in public health settings.
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