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.