Session/Event: Novel Approaches for Improving Public Health Through Better Nutrition (Oral 5)

(OR05-02-22) Hybrid Model of Intensive Lifestyle Intervention for Patients With Diabetes & Obesity for Post-COVID Era

On Demand

Presenting Author(s)

Shilton E. Dhaver, B.S.

Clinical Research Coordinator
Joslin Diabetes Center
Boston, Massachusetts, United States

Disclosure: Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

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Co-Author(s)

MA

Marwa Al Badri, M.D.

Joslin Diabetes Center
ST

Shaheen Tomah, MD

Research Fellow
Joslin Diabetes Center, Harvard Medical School
Boston, Massachusetts, United States
CK

Cara Kilroy, MSN, APRN, ANP-BC

Joslin Diabetes Center
JS

Jacqueline Shahar, MEd, RCEP, CDCES

Joslin Diabetes Center
CJ

Colleen Johnson, MS, RD, LDN

Joslin Diabetes Center
JV

Jennie Votta, DNP, FNP-C

Joslin Diabetes Center
CM

Christine Mitchell, MSW, LICSW

Joslin Diabetes Center
JB

Joan Beaton, B.A.

Joslin Diabetes Center
CD

Chandra Davis, B.S.

Joslin Diabetes Center
Osama Hamdy, MD, PhD

Medical Director, Obesity Clinical Program
Joslin Diabetes Center, Harvard Medical School
Boston, Massachusetts, United States

Objectives: The Weight Achievement and Intensive Treatment (Why WAIT) program is a 12-week multidisciplinary intensive lifestyle intervention (ILI) program for diabetes and weight management. We previously showed that the in-person model (iPM) of ILI has led to long-term maintenance of 6.9% weight loss for up to 10 yrs in real-world clinical practice. With the advent of the COVID-19 pandemic, we reported that a totally virtual model (VM) of the ILI program for the same duration was equally effective in reducing body weight and improving glycemic control. In this study, we test a newly introduced hybrid model (HM), combining 2 in-person sessions with 10 virtual sessions, to accommodate the prolonged restrictions of an ongoing pandemic.

Methods: We evaluated 46 participants (age 57±11 yrs; 52% females, 30% with type 1 diabetes) who enrolled in HM (n=8; A1C 6.79±0.97%; BMI 32.7±6.7 kg/m²), VM (n=16; A1C 7.73±1.32%; BMI 33.5±6.4 kg/m²) and iPM (n=22; A1C 7.98±1.09%; BMI 36.1±5.1 kg/m²) of the ILI program.

Results: At 12 weeks, body weight decreased from baseline in all three groups: mean reduction in HM (-7.46±3.77 kg; p=0.001), VM (-7.48±3.65 kg; p< 0.001), and iPM (-6.89±3.54 kg; p< 0.001). Moreover, A1C decreased from baseline in all three groups: mean reduction in HM (-0.44±0.54%; p=0.055), VM (-1.03±1.1%; p=0.002), and iPM (-1.00±1.2%; p=0.001). There were no significant differences in body weight reduction (p=0.89) or A1C (p=0.5) between groups. Furthermore, analysis of CGM data showed percentage Time-in-Range (%TIR) [70-180 mg/dL] at the end of each program was 82±12% in HM, 87±14% in VM, and 72±23% in iPM, with no significant differences between groups (p=0.3). Blood pressure, lipid profile, and number of anti-hyperglycemic medications also showed no significant differences between groups.

Conclusions: In conclusion, a hybrid model of the Why WAIT program is as effective as the virtual and the in-person models in reducing body weight and A1C after 12 weeks. Given its easy scalability, a hybrid model could potentially be offered to a larger number of patients with diabetes and obesity who may benefit from its increased flexibility and enhanced accountability without compromising the multidisciplinary team approach in post-COVID era.

Funding Sources: Funded internally at Joslin Diabetes Center