Both public health and clinical interventions are needed to stem the tide of obesity and diabetes. Although there is an important emphasis at a public health level on prevention, a sizable and growing portion of the population, currently 18.2 million adults, will seek clinical treatment for diabetes (36). Most of these individuals are overweight or obese. If this population is treated without a sustainable lifestyle component, their experience will be that of the ICAN usual care group: weight gain, increased waist circumference, and lower quality of life despite greater levels of medication. Although the magnitude of weight loss may not meet patients' and physicians' expectations, the benefits from the patient, clinical, and payer perspective outweigh the relatively low cost of such a program. If sustained, improvements of the magnitude achieved in ICAN could lead to reduced cardiovascular disease. Translation of lifestyle interventions into clinical care for obese patients with type 2 diabetes remains a challenge. An RD-led case management approach is one promising path toward achieving that goal.
Both public health and clinical interventions are needed to stem the tide of obesity and diabetes. Although there is an important emphasis at a public health level on prevention, a sizable and growing portion of the population, currently 18.2 million adults, will seek clinical treatment for diabetes (36). Most of these individuals are overweight or obese. If this population is treated without a sustainable lifestyle component, their experience will be that of the ICAN usual care group: weight gain, increased waist circumference, and lower quality of life despite greater levels of medication. Although the magnitude of weight loss may not meet patients' and physicians' expectations, the benefits from the patient, clinical, and payer perspective outweigh the relatively low cost of such a program. If sustained, improvements of the magnitude achieved in ICAN could lead to reduced cardiovascular disease. Translation of lifestyle interventions into clinical care for obese patients with type 2 diabetes remains a challenge. An RD-led case management approach is one promising path toward achieving that goal.
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