Clinic-based support to help overweight patients with type 2 diabetes increase physical activity and lose weight

被引:122
作者
Christian, James G. [1 ]
Bessesen, Daniel H. [2 ,3 ,5 ]
Byers, Tim E. [4 ]
Christian, Kyle K. [1 ]
Goldstein, Michael G. [6 ]
Bock, Beth C. [7 ,8 ]
机构
[1] Univ Colorado, Dept Med, Boulder, CO 80309 USA
[2] Univ Colorado Hlth Sci Ctr, Dept Med, Denver, CO USA
[3] Univ Colorado Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO USA
[4] Univ Colorado Hlth Sci Ctr, Univ Colorado Comprehens Canc Ctr, Denver, CO USA
[5] Denver Hlth Med Ctr, Dept Endocrinol, New Haven, CT USA
[6] InsHlth Care Commun, Dept Clin Educ & Res, New Haven, CT USA
[7] Brown Univ, Miriam Hosp, Brown Med Sch, Dept Psychiat & Human Behav, Providence, RI USA
[8] Brown Univ, Miriam Hosp, Dept Psychol, Ctr Behav & Prevent Med, Providence, RI USA
关键词
D O I
10.1001/archinternmed.2007.13
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Our objective was to test the effect of physicians providing brief health lifestyle counseling to patients with type 2 diabetes mellitus during usual care visits. Methods: We conducted a randomized controlled trial of a 12-month intervention at 2 large community health centers, enrolling 310 patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) of 25 or greater. In the intervention group, self-management goals for nutrition and physical activity were set using a tailored computer program. Goals were then reviewed at each clinic visit by physicians. The control group received only printed health education materials. The main outcome measures included change in physical activity and body weight. Results: In the intervention group, recommended levels of physical activity increased from 26% at baseline to 53% at 12 months (P<.001) compared with controls (30% to 37%; P=.27), and 32% of patients in the intervention group lost 6 or more pounds at 12 months compared with 18.9% of controls (odds ratio, 2.2; P=.006). Conclusion: A brief intervention to increase the dialogue between patients and health care providers about behavioral goals can lead to increased physical activity and weight loss.
引用
收藏
页码:141 / 146
页数:6
相关论文
共 33 条
[1]  
[Anonymous], 2000, Diabetes Care, V23 Suppl 1, pS1
[2]  
[Anonymous], CLIN GUID ID EV TREA
[3]   Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease [J].
Bassuk, SS ;
Manson, JE .
JOURNAL OF APPLIED PHYSIOLOGY, 2005, 99 (03) :1193-1204
[4]   Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood [J].
Bhargava, SK ;
Sachdev, HS ;
Fall, CHD ;
Osmond, C ;
Lakshmy, R ;
Barker, DJP ;
Biswas, SKD ;
Ramji, S ;
Prabhakaran, D ;
Reddy, KS .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (09) :865-875
[5]   ASSESSMENT OF HABITUAL PHYSICAL-ACTIVITY BY A 7-DAY RECALL IN A COMMUNITY SURVEY AND CONTROLLED EXPERIMENTS [J].
BLAIR, SN ;
HASKELL, WL ;
HO, P ;
PAFFENBARGER, RS ;
VRANIZAN, KM ;
FARQUHAR, JW ;
WOOD, PD .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1985, 122 (05) :794-804
[6]   A rapid food screener to assess fat and fruit and vegetable intake [J].
Block, G ;
Gillespie, C ;
Rosenbaum, EH ;
Jenson, C .
AMERICAN JOURNAL OF PREVENTIVE MEDICINE, 2000, 18 (04) :284-288
[7]   Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes [J].
Church, TS ;
LaMonte, MJ ;
Barlow, CE ;
Blair, SN .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (18) :2114-2120
[8]   Exercise capacity and body composition as predictors of mortality among men with diabetes [J].
Church, TS ;
Cheng, YJ ;
Earnest, CP ;
Barlow, CE ;
Gibbons, LW ;
Priest, EL ;
Blair, SN .
DIABETES CARE, 2004, 27 (01) :83-88
[9]   DIABETES SELF-MANAGEMENT EDUCATION [J].
CLEMENT, S .
DIABETES CARE, 1995, 18 (08) :1204-1214
[10]   Excess deaths associated with underweight, overweight, and obesity [J].
Flegal, KM ;
Graubard, BI ;
Williamson, DF ;
Gail, MH .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 293 (15) :1861-1867