University of Virginia Health System

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U.Va. HEALTH SYSTEM TO STUDY BENEFITS OF DIET & EXERCISE AMONG TYPE 2 DIABETICS IN VIRGINIA

Breaking a sweat and eating right can help control or prevent type 2 diabetes. But how to work with patients to act on the benefits of proper exercise and diet has confounded physicians and nurses for years.

Now, researchers at the University of Virginia Health System have been awarded a $3.5 million grant from the National Institutes of Health to study diet and exercise among type 2 diabetics. The idea is to translate current research findings about diabetes lifestyle management into everyday clinical practice so millions of diabetics worldwide may benefit.

Starting this month, 400 Virginia residents with type 2 diabetes will be enrolled in a randomized clinical trial, in cooperation with Southern Health Services, a statewide health care plan, and tracked for four years to document the ability of well-designed fitness and diet programs to control the disease.  The trial will be held at four sites in the commonwealth: Charlottesville, Harrisonburg, Roanoke and Richmond. 

“Physicians and other clinicians find it easy to write a prescription for a medication and patients usually know where to get it,” said Viktor Bovbjerg, principal investigator and assistant professor of health evaluation sciences at U.Va. “But they do not have a good way to write a prescription for diet and exercise. Patients when they leave the doctor’s office don’t know where to get that. The goal of this study is to have dieticians as case managers working with fitness experts, physicians and nurse practitioners and others to fill that gap by providing lifestyle case management to people with type 2 diabetes.”

Type 2, also known as adult onset diabetes, is the most common form of the disease and means that the body is able to produce insulin but cannot use it efficiently. Approximately 18 million Americans have type 2 diabetes, according to the American Diabetes Association. Nearly one third of those with diabetes don’t know they have it. More than 300 million people worldwide are at risk for developing diabetes and the economic impact, especially in developing nations, could be greater than that for the AIDS pandemic, according to the International Diabetes Federation. 

“We know that obesity is a major factor in type 2 diabetes and increases the risk of diabetes complications,” said Dr. Jerry Nadler, chief of the division of endocrinology and metabolism at U.Va. “This study could help find a strategy to deal with the ever-increasing epidemic of diabetes worldwide. It can also help raise awareness of the problem of obesity and provide potential solutions for physicians, other health care providers and patients. There are huge implications if this trial works successfully and can be extended nationally.”

The trial will work like this: the 400 participants will start off by receiving one year of intensive lifestyle intervention, tailored to each patient. The intervention will include meetings with dieticians and activity coaches, along with group education classes. “On top of their diabetes care, participants will be enrolled in fairly intense lifestyle management with a dietician to assist with and support dietary changes, and a trainer who will work with them to enhance physical activity – walking and other things they can do without necessarily having to go to a gym,” Bovbjerg said. 

In years two through four, half of the participants will keep receiving the lifestyle intervention. The other half, however, will only be monitored to see if the first year of diet and exercise improvements stick. “The preliminary results of our pilot study here at U.Va. show that intensive lifestyle intervention can help diabetics manage their disease without increasing health care costs,” said Anne Wolf, co-principal investigator and an instructor at U.Va.’s department of health evaluation sciences. “That’s a very attractive option to most health care plans today.

To be eligible, participants must be over 18 years old, have type 2 diabetes, a body mass index (BMI) over 27, and enrolled in Southern Health as their health care insuror.

The trial is free to participants, who will be contacted with information by Southern Health. Dietitians and fitness experts from each community will be involved in the study.

The first participants will be eligible to enroll beginning in April in Charlottesville. and Harrisonburg/ Shenandoah Valley, and beginning in June in Richmond and Roanoke.

For more information, contact the study project coordinator, Jayne Crowther, at (434) 924-9156 (Charlottesville) or toll-free at (866) 882-4226. Research questions should be directed to Viktor Bovbjerg, assistant professor in the department of health evaluation sciences at (434) 243-4874 or  bovbjerg@virginia.edu.

March 10, 2004