Effects of a Multicomponent Life-Style Intervention on Weight, Glycemic Control, Depressive Symptoms, and Renal Function in Low-Income, Minority Patients with Type 2 Diabetes: Results of the Community Approach to Lifestyle Modification for Diabetes Randomized Controlled Trial

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Abstract

Objective Few interventions have combined life-style and psychosocial approaches in the context of Type 2 diabetes management. The purpose of this study was to determine the effect of a multicomponent behavioral intervention on weight, glycemic control, renal function, and depressive symptoms in a sample of overweight/obese adults with Type 2 diabetes and marked depressive symptoms. Methods A sample of 111 adults with Type 2 diabetes were randomly assigned to a 1-year intervention (n = 57) or usual care (n = 54) in a parallel groups design. Primary outcomes included weight, glycosylated hemoglobin, and Beck Depression Inventory II score. Estimated glomerular filtration rate served as a secondary outcome. All measures were assessed at baseline and 6 and 12 months after randomization by assessors blind to randomization. Latent growth modeling was used to examine intervention effects on each outcome. Results The intervention resulted in decreased weight (mean [M] = 0.322 kg, standard error [SE] = 0.124 kg, p =.010) and glycosylated hemoglobin (M = 0.066%, SE = 0.028%, p =.017), and Beck Depression Inventory II scores (M = 1.009, SE = 0.226, p <.001), and improved estimated glomerular filtration rate (M = 0.742 ml·min -1 ·1.73 m -2, SE = 0.318 ml·min -1 ·1.73 m -2, p =.020) each month during the first 6 months relative to usual care. Conclusions Multicomponent behavioral interventions targeting weight loss and depressive symptoms as well as diet and physical activity are efficacious in the management of Type 2 diabetes. Trial Registration: This study is registered at Clinicaltrials.gov ID: NCT01739205.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalPsychosomatic medicine
Volume78
Issue number7
DOIs
StatePublished - Sep 1 2016

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Keywords

  • Type 2 diabetes
  • depression
  • glycemic control
  • life-style intervention
  • obesity
  • renal function

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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