A 12 Step Program for the Treatment of Type 2 Diabetes and Obesity

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 839-872-Diabetes & Obesity Management
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-846
Michael K Laidlaw*1 and Wei-An Andy Lee2
1Michael K Laidlaw MD inc., Rocklin, CA, 2Univ of Southern CA, South Pasadena, CA
Background: 

Type 2 diabetes (DM2) and obesity are very difficult conditions to treat without medical or surgical intervention. Dietary interventions have been only moderately successful in treating these conditions. Increasing research evidence points towards food addiction as a cause of obesity in some patients. The hypothesis of this study is that food addiction may also be a cause of DM2 in some patients. Therefore, a focused program to treat food addiction should help reduce HBA1c and weight.

Methods: 

A retrospective chart review was undertaken of 5 males and 1 female patient with DM2 who had joined the Food Addicts in Recovery Anonymous (FA) program. FA is modeled on Alcoholics Anonymous. Participants attend meetings several days per week and have a sponsor who they call daily and who creates a customized food program. They do not consume any sugar or flour and weigh all of their food. Baseline characteristics (mean): age 64.4 ±  12 yrs, diabetes duration 17 ±  10 yrs, wt 120.2  ±  20 kg, BMI 38.2 ± 4 kg/m2, BP 125/74 ± 14/17 mm Hg, HBA1c 8.03 ± 1.5%, T chol 177 ± 35 mg/dl , LDL 106 ± 25 mg/dl, HDL 41 ± 7 md/dl, Trig 157 ± 101 mg/dl. All patients took either oral diabetes medication, insulin, or a combination. 5 out of 6 patient took long acting insulin of 45.6 ± 24 u per day. 

Results:

Six patients followed the FA program for a mean 7.3 ± 4.4 months. Cumulative time in the program was 44 months with a total weight loss of 114 kg. Mean weight fell significantly  (-19.4 ± 34 kg; p = 0.0258). Blood pressure lowered modestly (SBP -2 ± 8 mm Hg, DBP -8 ± 12 mm Hg; NS). Mean HBA1c fell (1.6 ±  1.1%; P = 0.09). Mean changes in lipids: T chol -33.7 ± 36 mg/dl, LDL -26.3 ±  20 mg/dl, HDL 3.7 ± 9 mg/dl, Trig -59.3 ± 79 mg/dl (NS). All patients had a reduction in diabetes medication. The average daily usage of long acting insulin was decreased by 27.2 u ± 14 u. 5 out 6 patients achieved a goal HBA1c of < 7%.

Discussion: 

This study shows that it is possible to not only reduce weight substantially, but also lower blood glucose levels to goal by approaching diabetes as an outcome of food addiction. By eating a very specific diet as well as following the 12 steps of the FA program, participants were able to reduce HBa1c, weight, and medication burden including insulin. Extended studies would be useful to know if reductions in blood glucose and weight can be maintained in a majority of patients for a longer duration of time.

Nothing to Disclose: MKL, WAAL

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm