Diabetes Mellitus Type 2 in Obese Clinical Trial
Nutrition therapy is recognized as one of the crucial components for the standard treatment
of diabetes along with physical activity and drug therapy. Of note, dietary habits are
culture specific and hence understanding the dietary intake, eating behavior and physical
activity level of the local population is important to formulate effective nutrition and
lifestyle strategies. Weight control is a major therapeutic challenge because many
conventionally used anti-diabetic agents, such as sulphonylurea and insulin, can cause weight
gain, thus setting up a vicious cycle with increasing insulin resistance due to increasing
levels of free fatty acids from adipose tissues . Although intensive face-to-face lifestyle
intervention program has showed that even modest weight loss in people with Type 2 diabetes
(T2DM) who were overweight or obese was associated with improvements in glycemic control and
associated conditions, it may not be feasible in public hospital setting in Hong Kong due to
factors such as limited resources, scheduling, patient's employment and willingness for
frequent travel to the clinic. Hence, alternative strategies such as a combination of face-
to-face individual dietary and lifestyle consultation together with telephone intensive
lifestyle reinforcement program will likely to be an useful strategy to engage those obese
T2DM patients through frequent individual contacts. On the other hand, bariatric surgery has
emerged as an impressive therapeutic option for poorly control obese T2DM patients.
Realizing there is a knowledge gap in understanding the lifestyle factors in the Hong Kong
Chinese obese T2DM patients, we therefore propose to conduct a 1-year prospective clinical
trial with two main objectives:
1. To study and compare the glycemic and weight improvement after bariatric surgery versus
a telephone intensive lifestyle intervention program for 1 year in Hong Kong Chinese
obese patients with type 2 diabetes.
2. To investigate the effect of lifestyle factors including dietary intake, eating
behaviors and physical activity level on the glycemic and weight control of Hong Kong
Chinese obese patients with type 2 diabetes.
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