Participation in a multicomponent lifestyle intervention for people with obesity improves glycated hemoglobin (HbA1c)

Introduction: Obesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA(1c). The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA(1c). Research design and methods: Patients with a BMI >= 30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA(1c) and body weight a clinically relevant change of 5 >= mmom/mol and 5%>=, respectively, was chosen. Participants were divided into groups according to their baseline HbA(1c) level: "Diabetes": HbA(1c) of >= 6.5% (>= 48 mmol/mol), "Prediabetes": HbA(1c) of 5.7% to 6.4% (39-47.99 mmol/mol) or "Normal" HbA(1c) <5.7% (<39 mmol/mol). Results: 180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25(th);75(th) quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA(1c) was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA(1c) (<39) and 30% patients with diabetes reduced their HbA(1c) <48. All groups had clinically relevant (>= 5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA(1c) reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01). Conclusion: In this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA(1c) after 6-months. More than 1/3 of patients with prediabetes normalized their HbA(1c).