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Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

Publication ,  Journal Article
Crowley, MJ; Edelman, D; Voils, CI; Maciejewski, ML; Coffman, CJ; Jeffreys, AS; Turner, MJ; Gaillard, LA; Hinton, TA; Strawbridge, E; Yancy, WS ...
Published in: Contemp Clin Trials
July 2017

BACKGROUND: Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) intervention for diabetes that emphasizes weight management could improve glycemic outcomes and reduce weight while simultaneously lowering diabetes medication needs, resulting in less hypoglycemia and better quality of life. We describe the rationale and design for a study evaluating a novel SMA intervention for diabetes that primarily emphasizes low-carbohydrate diet-focused weight management. METHODS: Jump Starting Shared Medical Appointments for Diabetes with Weight Management (Jump Start) is a randomized, controlled trial that is allocating overweight Veterans (body mass index≥27kg/m2) with type 2 diabetes into two arms: 1) a traditional SMA group focusing on medication management and self-management counseling; or 2) an SMA group that combines low-carbohydrate diet-focused weight management (WM/SMA) with medication management. Hemoglobin A1c reduction at 48weeks is the primary outcome. Secondary outcomes include hypoglycemic events, diabetes medication use, weight, medication adherence, diabetes-related quality of life, and cost-effectiveness. We hypothesize that WM/SMA will be non-inferior to standard SMA for glycemic control, and will reduce hypoglycemia, diabetes medication use, and weight relative to standard SMA, while also improving quality of life and costs. CONCLUSIONS: Jump Start targets two common problems that are closely related but infrequently managed together: diabetes and obesity. By focusing on diet and weight loss as the primary means to control diabetes, this intervention may improve several meaningful patient-centered outcomes related to diabetes.

Duke Scholars

Published In

Contemp Clin Trials

DOI

EISSN

1559-2030

Publication Date

July 2017

Volume

58

Start / End Page

1 / 12

Location

United States

Related Subject Headings

  • Weight Reduction Programs
  • Weight Loss
  • Veterans
  • Single-Blind Method
  • Self-Management
  • Research Design
  • Quality of Life
  • Public Health
  • Patient Education as Topic
  • Overweight
 

Citation

APA
Chicago
ICMJE
MLA
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Crowley, M. J., Edelman, D., Voils, C. I., Maciejewski, M. L., Coffman, C. J., Jeffreys, A. S., … Yancy, W. S. (2017). Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial. Contemp Clin Trials, 58, 1–12. https://doi.org/10.1016/j.cct.2017.04.004
Crowley, Matthew J., David Edelman, Corrine I. Voils, Matthew L. Maciejewski, Cynthia J. Coffman, Amy S. Jeffreys, Marsha J. Turner, et al. “Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.Contemp Clin Trials 58 (July 2017): 1–12. https://doi.org/10.1016/j.cct.2017.04.004.
Crowley MJ, Edelman D, Voils CI, Maciejewski ML, Coffman CJ, Jeffreys AS, et al. Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial. Contemp Clin Trials. 2017 Jul;58:1–12.
Crowley, Matthew J., et al. “Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.Contemp Clin Trials, vol. 58, July 2017, pp. 1–12. Pubmed, doi:10.1016/j.cct.2017.04.004.
Crowley MJ, Edelman D, Voils CI, Maciejewski ML, Coffman CJ, Jeffreys AS, Turner MJ, Gaillard LA, Hinton TA, Strawbridge E, Zervakis J, Barton AB, Yancy WS. Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial. Contemp Clin Trials. 2017 Jul;58:1–12.

Published In

Contemp Clin Trials

DOI

EISSN

1559-2030

Publication Date

July 2017

Volume

58

Start / End Page

1 / 12

Location

United States

Related Subject Headings

  • Weight Reduction Programs
  • Weight Loss
  • Veterans
  • Single-Blind Method
  • Self-Management
  • Research Design
  • Quality of Life
  • Public Health
  • Patient Education as Topic
  • Overweight