Strategy to support weight management in type 2 diabetes

Background: The prevalence of Type 2 diabetes is increasing rapidly. Weight loss has clinical benefits so that weight management is a key focus in the clinical care of patients with diabetes (RCP 2008). Studies examining telephone follow-up of patients for glycaemic control have shown positive effects (Piette, 2007). Aims: An exploratory trial following the MRC framework (MRC 2000) aimed to explore the impact of telephone follow-up strategy to promote weight management. Method: An exploratory trial of 46 participants recruited from a diabetes care centre in a NHS Trust in England were randomised into an intervention group (n=25) or a control group (n=21). The intervention group received a weekly telephone follow-up of the advice given in the dietician’s clinic for 12 weeks. The control group received routine care. Result: There were no significant differences in weight loss, metabolic control and psychological well-being between the groups at 3 months follow-up, however, more participants in the intervention group advanced regarding the level of the Stages of Change compared to those in the control group. The clinical and interview data indicated that telephone follow-up was a feasible approach and well accepted by the participants and their families. Discussion: The findings indicate that weight loss is a very complex issue, the findings of this study highlighted that educational approaches in isolation may be too weak to impact upon weight management. There are many other factors that may impact upon behaviour change, therefore macro interventions other than individule targetted strategies.