Joslin Diabetes Center, Boston, MA, United States.
Harvard Medical School, Boston, MA, United States.
Front Endocrinol (Lausanne). 2023 Jan 17;13:1050527. doi: 10.3389/fendo.2022.1050527. eCollection 2022.
The Weight Achievement and Intensive Treatment (Why WAIT) program is a 12-week multidisciplinary intensive lifestyle intervention (ILI) for patients with diabetes and obesity in real-world clinical practice that has led to long-term weight loss maintenance for up to 10 years. During COVID-19, we reported that a virtual model (VM) of the program was equally effective in reducing body weight and improving glycemic control. Here, we test a newly-introduced hybrid model (HM), to accommodate ongoing restrictions of the pandemic. We evaluated 56 participants: 18 from HM, 16 from VM and 22 from the in-person model (iPM). At 12 weeks, mean change in body weight from baseline for HM was -8.2 ± 5.0 kg; p<0.001. Mean change in A1C for HM was -0.6 ± 0.6%; p=0.002. There were no significant differences in body weight reduction (p=0.7) or A1C reduction (p=0.6) between groups. Blood pressure, lipid profile, and all other parameters showed improvements without significant differences between groups. Overall, HM is as effective as VM and iPM in reducing body weight and A1C after 12 weeks. Given its scalability, HM could be offered to more patients with diabetes and obesity who may benefit from its increased flexibility and enhanced accountability without compromising the multidisciplinary approach for a post-COVID era.
体重达标与强化治疗（Why WAIT）计划是一种为期 12 周的多学科强化生活方式干预（ILI），适用于现实临床实践中的糖尿病和肥胖患者，可实现长达 10 年的长期体重维持。在 COVID-19 期间，我们报告称该计划的虚拟模型（VM）在减轻体重和改善血糖控制方面同样有效。在这里，我们测试了一种新引入的混合模型（HM），以适应大流行期间持续存在的限制。我们评估了 56 名参与者：18 名来自 HM，16 名来自 VM，22 名来自面对面模型（iPM）。在 12 周时，HM 的体重从基线的平均变化为-8.2 ± 5.0kg；p<0.001。HM 的 A1C 平均变化为-0.6 ± 0.6%；p=0.002。组间体重减轻（p=0.7）或 A1C 降低（p=0.6）无显著差异。血压、血脂谱和所有其他参数均有所改善，组间无显著差异。总体而言，HM 在 12 周后在减轻体重和 A1C 方面与 VM 和 iPM 一样有效。鉴于其可扩展性，HM 可以提供给更多患有糖尿病和肥胖症的患者，他们可能受益于其增加的灵活性和增强的问责制，而不会影响大流行后的多学科方法。
