A holistic approach to health is needed to help people eat healthy, exercise and stay well, according to a new study.
A low-calorie diet and significant weight loss allowed people with diabetes and high blood pressure to reduce their medication for both conditions in a small international study.
Adding to the body of evidence on the effectiveness of lifestyle factors in the management of diabetes and other chronic diseases, the UK Direct One study found that the 12-week low-calorie soup and shake program could lead to remission from type 2 diabetes and lower blood pressure.
Dr Gary Deed, President of the RACGP Diabetes Specific Interest Network, said gp news the study strengthens current guidelines for considering approaches to weight loss, education and healthy eating.
“Even though patients have been taking medication for a long time, as in this study with medication for hypertension, the lifestyle [changes] have shown significant benefits in some patients, ”he said.
“This study reinforces the fact that focusing on significant weight loss, if achievable, can alter people’s need for blood pressure medication.
“This only further reinforces the fact that … GPs are able to walk patients through different lifestyle processes, one of which is a very low calorie weight loss diet program, but it must be individualized. “
Dr Deed notes that the study was only a short pilot trial on early-stage diabetes, and not all 143 participants achieved significant weight loss that affected their blood pressure medication.
Posted in Diabetology, the study involved following a complete 830-calorie diet that would induce a weight loss of more than 15 kg in 12 weeks.
Participants stopped their medications at the start of the trial, but resumed taking them if their diabetes or hypertension control was reduced. This occurred in 28 percent of the test cohort.
He found that average blood pressure drops as people lose weight and continues to drop after dieting is over.
Dr Deed said that while the low-calorie diet “is not impossible” in general practice, supportive services are needed.
“This is a model that we can try to work on, with a licensed practicing dietitian, appropriate psychological support services for patients,” he said.
He said obesity and weight management are built into the RACGP diabetes management guidelines, including eating according to Australian dietary guidelines, advising overweight or obese people and type 2 diabetes for weight loss, and physical activity.
“It is worthwhile to assess all patients individually and give them a chance,” Dr Deed said. “It can put their diabetes in remission and support other management such as reducing medication and improving cardiovascular fitness.
“Those at risk and those newly diagnosed should really be offered lifestyle support from the start.
“It’s not just the responsibility of general practitioners. It is a holistic approach to health.
“It’s really a call to policy makers to help align political and economic support with prevention activities. “
These materials are publicly available in some states, said Dr Deed, pointing to the Get Healthy Information and Coaching service. in queensland and in New South Wales which offers personalized help for healthy eating.
“The guidelines encourage doctors to start the tablets, but there has been little demonstration of how the tablets can be stopped,” Professor Roy Taylor of Newcastle University said in a statement.
“My patients, like so many others, don’t like to swallow multiple pills, and this study is important because we can now reassure them that stopping blood pressure pills is not only safe, but also good. for their health.
“We have shown that when substantial weight loss is achieved and maintained, patients can effectively manage both their blood pressure and type 2 diabetes without medication. “
One of the study’s authors, Professor Mike Lean of the University of Gladgow, said the researchers were satisfied with the results of the study, which aimed to assess the safety and effectiveness of removing the high blood pressure medication at the start of the weight loss program.
“The DiRECT trial was performed entirely in primary care,” he said.
“Evidence shows that general practitioners can safely offer an intensive, evidence-based weight management intervention aimed at substantial weight loss and remission in type 2 diabetes.
“The study highlights the links between diet, weight, type 2 diabetes and hypertension, and how vital long-term support to maintain weight loss is.”
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