Abstract
Obese Veterans with diabetes and other comorbidities are at increased risk for complications and mortality. In this pilot, we examined the effectiveness of a multidisciplinary virtual intervention aimed to achieve weight loss and improve glycemic control in 10 high-risk obese Veterans with diabetes. Inclusion criteria were: age 18-75, BMI ≥ 30, A1c ≥ 8% or on high insulin doses (≥ 1 unit/kg or any dose of U-500 insulin), and at least one of the following: cardiovascular, kidney, nonalcoholic fatty liver, degenerative joint disease, or sleep apnea. All patients were recruited by the MOVE! Coordinator and enrolled in the Home Telehealth Program for diabetes and weight management. Participants worked with the dietitian to restrict carbohydrate intake (goal of 30-45 grams/meal) and with the occupational therapist to increase their physical activity through virtual sessions. A clinical pharmacist reviewed medications and made therapeutic recommendations in collaboration with the diabetes physician. Weekly huddles were held where information including glucose trends were discussed for each patient. With a mean duration of 5.5 months, participants have shown on average significant weight loss (-21.5 lbs or - 8.3%), improvement in glycemic control (-1.1% A1c), and decreased total daily insulin doses (-52.6%). At the end of the 12 months pilot duration, changes in other cardiometabolic markers, impact on quality of life, and cost will be assessed.View largeDownload slideView largeDownload slide DisclosureC. E. Mendez: None. J. M. Hansen: None. A. Feest: None. J. Taxman: None. K. Bertram: None. A. V. Hanley: None.
Published Version
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