416-P: Effect of Intensive Lifestyle Intervention on Renal Function in Patients with Diabetes and Obesity—A 10-Year Longitudinal Study

Diabetic nephropathy is a common complication of diabetes mellitus (DM). In this study, we evaluated renal function in patients with DM and obesity 10 years after participating in a multidisciplinary intensive lifestyle intervention (ILI). We evaluated 94 patients with obesity and DM (12.8% type 1 DM and 87.2% type 2 DM) with mean age of 53.9±9.9 years and mean diabetes duration of 10.9±10.3 years who enrolled in a 12-week ILI in real-world clinical practice. At one year, we stratified participants according to their percentage weight loss into: group A, who maintained ≥7% weight loss (48.9%) and group B, who maintained <7% weight loss (51.1%), and followed them for 10 years. At 10 years, group A lost an average of 9.6±11.2 kg (8.5±10%, p<0.0001) and group B lost an average of 4.1±9.7 kg (4.0±9.4%, p=0.004). A1C did not change from baseline in group A, but significantly increased in group B (+0.8±1.9%, p=0.008). Systolic and diastolic blood pressure decreased in both groups but were only statistically significant in group A from (from 132±15.9/ 76.9±9.1 mmHg at baseline to 125.6±14.4/ 73.4±9.3 mmHg at 10 years, p=0.02, p=0.047 respectively). Serum creatinine significantly decreased in group A from 0.92±0.2 mg/dL to 0.86±0.2 mg/dL (p=0.013) but did not change in group B (0.93±0.2 mg/dL to 0.89±0.3 mg/dL). eGFR significantly increased in group A from 83.3±27 to 90.3±34 mL/min/1.73 m² (p=0.03) and in group B from 80.2±24 to 89.5±44 mL/min/1.73 m² (p=0.046). There was no significant change in urinary albumin/creatinine ratio in both groups. LDL-cholesterol and HDL-cholesterol significantly improved in both groups. We conclude that 12 weeks of ILI improves renal function for up to 10 years after intervention. This improvement is particularly evident in those who maintained ≥7% weight loss at one year.