Improvement in Glycemic Control in Patients with DM Is Not Dependent on Weight Loss in a Diabetes Self-Management Education Program

Presentation Number: SUN 632
Date of Presentation: April 2nd, 2017

Christine McElyea*1, Srilatha Venepally1, Jennifer Hoang1 and Soe Naing2
1UCSF Fresno Medical Education Program, Fresno, CA, 2University of California, San Francisco, Fresno Medical Education Program, Fresno, CA

Abstract

Background: Diabetes self-management education (DSME) is the vital part of diabetes mellitus (DM) management. It is well known that DSME results in improvement in glycemic control. However, there is limited information on whether such improvement is dependent on weight loss in a DSME program.

Objective: The purpose of this study is to determine whether improvement in glycemic control in patients with DM is dependent on weight loss in a DSME program.

Method: This is a retrospective study involving the patients with DM type 1 or type 2 who attended all 4 classes in the DMSE program at an ADA-accredited community diabetes care center between 1/1/2011 and 12/31/2015. The inclusion criteria were non-pregnant adults, baseline A1C 6.5% or higher, age over 18 years and those with A1C and weight results available at both first and final visits. Clinical and laboratory data were collected from the electronic medical records at the first and final visits.

Results: 501 patients with DM (mean age 53 years, men 38%, Hispanics 60.4%) were included. Baseline mean values were A1C 9.8%, weight 205.9 lbs and BMI 34.2. Mean A1C decrease was 1.6% (p<0.0001), mean weight gain was 0.75 lbs (p=0.1), and mean BMI increase was 0.67(p=0.3). There was a negative correlation between A1C change and weight change (Pearson Correlation -0.152; Adjusted R20.021; p=0.001). There was a significant weight gain in Hispanics (1.81 lbs; p=0.03) but there was a non-significant weight loss in non-Hispanics (-0.86 lbs; p=0.31). Both Hispanics and non-Hispanics had significant decrease in A1C (-1.64% vs -1.53%).

Discussion: This study showed that the patients in a DSME program achieved a significant reduction in A1C despite having a slight weight gain. There was a negative correlation between A1C change and weight change. These results suggested that A1C reduction in these patients is not dependent on the weight loss. The potential explanation for weight gain includes initiation of the glucose-lowering agents associated with weight gain such as insulin or sulfonylurea and the improved compliance with these medications during the education period.

Conclusion: Improvement in glycemic control in patients with DM is not dependent on weight loss in a DSME program.

 

Nothing to Disclose: CM, SV, JH, SN