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The psychological component of comprehensive lifestyle modification program in overweight (obese) patients with type 2 diabetes mellitus

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Background. Despite the emergence of new modern classes of antihyperglycemic medications, lifestyle modification of patient with type 2 diabetes mellitus (T2DM) is a necessary component of the therapeutic approach in this disease. Clinically significant weight reduction and its maintenance is extremely important, but elusive goal for most patients with T2DM in the real clinical practice. The use of specially developed programs with involvement of the different profiles specialists (endocrinologists, dieticians, psychologists, instructors or сlinical exercise physiologists) can greatly contribute to this task.

Aims — to study individual psychological characteristics in overweight (obese) patients with T2DM and to evaluate the dynamic of these characteristics, anthropometric, clinical and metabolic parameters during the comprehensive lifestyle modification program.

Material and methods. The lifestyle modification program was developed. The main structural components of this program were dietary intervention, dosed individualized exercise intervention, specific model of team psychotherapeutic work (health coaching), comprehensive group education and dynamic medical support of patients with the adaptation of drug therapy. Psychological characteristics of patients, clinical and metabolic parameters and the level of physical activity were assessed before inclusion, at 3 and 12 months of follow-up.

Results. The study was completed by 55 people of 60 (5 people dropped out of the study because of various reasons). There were not undesirable phenomena, directly related to participation in the program. At the end of the study we noted the positive dynamics of psychological characteristics in patients: 15% of men and 22% of women became less inclined to self-blame and hyper-responsibility; the locus of control in a relationship to own capabilities of health management changed from external to internal in 30% of women and 41% of men. 65% of participants achieved clinically significant weight loss (most patients reduced MT by 10% or more) and retained this result during 1 year. Improvement of clinical and metabolic parameters was also noted.

Conclusions. The multidisciplinary lifestyle modification program in overweight (obese) patients with T2DM, the most important part of which was team psychotherapeutic work, showed high effectiveness of both the reduction of MT and the improvement of clinical and metabolic parameters in the long-term period.

Svetlana I. Andreeva

Endocrinology Research Centre

Author for correspondence.
Email: sveta--1989@yandex.ru
ORCID iD: 0000-0002-6391-8551
SPIN-code: 1292-0690

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036


Larisa M. Rudina

The Russian Presidential Academy of National Economy and Public Administration

Email: rudina.larisa@gmail.com
ORCID iD: 0000-0001-8405-1347
SPIN-code: 4748-8603

Russian Federation, 119571, Moscow, Vernadskogo av., 82

PhD in psychology

Larisa V. Savelyeva

Endocrinology Research Centre

Email: slv63@mail.ru
ORCID iD: 0000-0002-2808-4846
SPIN-code: 1452-8793

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036


Maria V. Gurkina

Medical Rehabilitation Centre

Email: pare-brise@mail.ru
ORCID iD: 0000-0003-1035-9220
SPIN-code: 2429-6464

Russian Federation, 3, Ivankovskoe shosse, Moscow, 125367


Elena V. Surkova

Endocrinology Research Centre

Email: elenasurkova@mail.ru
ORCID iD: 0000-0002-3973-7638
SPIN-code: 7944-3869

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036


Gagik R. Galstyan

Endocrinology Research Centre

Email: galstyangagik964@gmail.com
ORCID iD: 0000-0001-6581-4521
SPIN-code: 9815-7509

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, PhD, Professor

Marina V. Shestakova

Endocrinology Research Centre

Email: shestakova.mv@gmail.com
ORCID iD: 0000-0002-5057-127X
SPIN-code: 7584-7015

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, PhD, Professor

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Supplementary files

Supplementary Files Action
1. Fig. 1. Results by the test "Scale of control of the action" by Yu. Kul (points): the dashed line indicates the average normative values for the test. View (63KB) Indexing metadata
2. Fig. 2. Features of attribution (points). View (43KB) Indexing metadata
3. Fig. 3. Preferred Attribute Scale (%). View (39KB) Indexing metadata
4. Fig. 4. Changes in the thinking style of the program (%). View (47KB) Indexing metadata


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Copyright (c) 2018 Andreeva S.I., Rudina L.M., Savelyeva L.V., Gurkina M.V., Surkova E.V., Galstyan G.R., Shestakova M.V.

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