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Metabolic Outcomes in Patients With Type 2 Diabetes Prescribed Incretin‐Based Therapy and Referred or Not to a Weight Management Clinic: A Single‐Center Retrospective Analyses
Journal article   Open access   Peer reviewed

Metabolic Outcomes in Patients With Type 2 Diabetes Prescribed Incretin‐Based Therapy and Referred or Not to a Weight Management Clinic: A Single‐Center Retrospective Analyses

Kathleen M. Robinson, Stephanie H. Rodriguez, Cyril Pedagarla, Patrick Tel Eyck, Marcelo Correia and Ayotunde Dokun
Obesity science & practice, Vol.12(1), e70114
02/2026
DOI: 10.1002/osp4.70114
PMCID: PMC12791153
PMID: 41531807
url
https://doi.org/10.1002/osp4.70114View
Published (Version of record) Open Access

Abstract

Background Incretin therapies yield strong metabolic improvements, but whether adding a weight-management (WM) clinic confers additional benefit beyond pharmacotherapy alone in routine care is unclear. Objective Evaluate whether referral to WM clinic, alongside standard diabetes care, provides additional benefit for adults with type 2 diabetes (T2DM) and obesity treated with incretin therapies regarding changes in A1c, body weight, and LDL. Methods Retrospective cohort study within an academic health system (2018–2023); adults with T2DM and obesity initiating an incretin were grouped by care model (diabetes care alone, DM, vs. diabetes care plus WM clinic, DM + WM). N = 1445 (DM n = 1,163, DM + WM n = 282). The DM + WM group was stratified based on the number of visits. Primary outcomes were change from baseline to last follow-up in A1c (%), body weight (kg), and LDL (mg/dL). Weighted linear models reported within-group changes and between-group adjusted mean differences with 95% CIs, controlling for baseline values and prespecified covariates (sex, race/ethnicity, age, comorbidity, medication categories, care period). Results Among 1445 patients (DM n = 1163; DM + WM n = 282), both groups improved from baseline: weight −4.95 versus −6.00 kg, A1c −0.38% versus −0.37%, LDL −12.19 versus −11.60 mg/dL (all within-group p < 0.05). In adjusted models, the DM + WM (1 visit) group lost less weight than the DM group by +4.1 kg (95% CI 1.2–7.1 kg; p = 0.006) while the DM + WM (4 + visit) group lost more weight with of −4.4 kg (95% CI −6.7 to −2.0 kg, p = 0.0003). Other differences were not statistically significant: A1c + 0.01% (−0.27 to 0.28; p = 0.96), LDL + 0.58 mg/dL (−6.01 to 7.16; p = 0.86). Conclusion Among adults starting incretin therapy in routine practice, significant improvements in A1c, weight, and LDL were observed. Patients attending one weight management visit lost less weight than those attending only the DM clinic, while those attending 4 + WM visits lost significantly more weight. Potential long-term effects of WM-based support were not assessed.
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