Level 2: Mid-level evidence

The efficacy of clinic-based support using individualized self-management goals vs. usual care was evaluated in a randomized trial of 310 Latino/Hispanic patients with type 2 diabetes and BMI >25 (Arch Intern Med. 2008;168:141-146). Goals for nutrition and physical activity were established by a specialized computer program and then reviewed by a physician at each clinical visit. Usual care included provision of printed health-education materials. All patients returned for office visits every three months for 12 months. The analysis included 273 patients (88%) who completed the study; 37 patients (12%) dropped out.

Comparing intervention vs. control, 21% vs. 10.6% had sustained weight loss (5% total body weight) at 12 months (P<.01, NNT 10); mean weight change was -0.18 pounds vs. +1.39 pounds (-0.08 kg vs. +0.6 kg) (not significant). Physical activity level increased with intervention (P<.001) but not with usual care (P=.27).