Poster Presentation ANZOS-ASLM-ICCR 2019

Six month weight loss in patients with severe obesity with and without Type 2 Diabetes in a public metabolic program (#175)

David M Medveczky 1 , Raymond Kodsi 2 , Kathryn Skelsey 1 2 , Kathy Grudzinskas 2 , Flavia Bueno 1 2 , Vincent Ho 1 2 , Nic Kormas 2 3 , Milan Piya 1 2
  1. Western Sydney University, Campbelltown, NSW, Australia
  2. Campbelltown and Camden Hospitals, Campbelltown, New South Wales, Australia
  3. Concord Hospital, Concord, New South Wales, Australia

Introduction

Severe obesity is associated with considerable medical and psychosocial comorbidity. Insulin use in Type 2 Diabetes (T2DM) can exacerbate obesity, while optimisation of medications may aid weight loss. We aimed to determine baseline characteristics of patients in a publicly funded metabolic program and whether having T2DM influenced weight loss at 6 months. 

Methods

All new patients attending a publicly funded metabolic program in NSW from March 2018 to March 2019 had data collected at baseline and 6 months. All patients were offered on-site supervised exercise in addition to multidisciplinary care.

Results

Of 180 patients that entered the service, 53% had T2DM. Patients with T2DM were older (52.5±13.2 vs 46.6±14.4 years, p<0.01) and had more hypertension (43.8% vs 25%, p<0.001), dyslipidaemia (79.2% vs 41.7%, p<0.001) and CKD stage 3 (18.8% vs 6%, p<0.05), with no difference in BMI (50.3±7.6 vs 52.5±10.5 kg/m2) or gender (68% vs 60% female). Six month data were available for 84% of patients who had been in the program for ≥6 months (n=116). Weight loss at 6 months was similar for patients with or without T2DM (5.9±7.1 vs 4.4±5.7kg, p=0.26). Patients with T2DM achieved better glycaemic control compared to baseline (HbA1c 7.8%±1.7 vs 7.3%±1.3, p<0.001), despite fewer patients being on insulin (35% vs 30%, p<0.001) and lower doses of insulin at six months (158.9±105.1 vs 88.5±62.3 units, p<0.01). There was no significant difference in supervised exercise enrolment (57.3% vs 42.6%, p=0.37) or class attendance (1.78±0.94 vs 1.71±0.84 sessions per week) between patients with and without T2DM.

Conclusion

Patients entering the metabolic program were older, heavier and had more co-morbidities compared with other published Australian data including the bariatric surgery registry. Despite being older and having more co-morbidities, patients with T2DM achieved similar weight loss, with additional benefits of improved glycaemia and reduced insulin requirements.