Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial
Look AHEAD Research Group, Xavier Pi-Sunyer, George Blackburn, Frederick L Brancati, George A Bray, Renee Bright, Jeanne M Clark, Jeffrey M Curtis, Mark A Espeland, John P Foreyt, Kathryn Graves, Steven M Haffner, Barbara Harrison, James O Hill, Edward S Horton, John Jakicic, Robert W Jeffery, Karen C Johnson, Steven Kahn, David E Kelley, Abbas E Kitabchi, William C Knowler, Cora E Lewis, Barbara J Maschak-Carey, Brenda Montgomery, David M Nathan, Jennifer Patricio, Anne Peters, J Bruce Redmon, Rebecca S Reeves, Donna H Ryan, Monika Safford, Brent Van Dorsten, Thomas A Wadden, Lynne Wagenknecht, Jacqueline Wesche-Thobaben, Rena R Wing, Susan Z Yanovski, Look AHEAD Research Group, Xavier Pi-Sunyer, George Blackburn, Frederick L Brancati, George A Bray, Renee Bright, Jeanne M Clark, Jeffrey M Curtis, Mark A Espeland, John P Foreyt, Kathryn Graves, Steven M Haffner, Barbara Harrison, James O Hill, Edward S Horton, John Jakicic, Robert W Jeffery, Karen C Johnson, Steven Kahn, David E Kelley, Abbas E Kitabchi, William C Knowler, Cora E Lewis, Barbara J Maschak-Carey, Brenda Montgomery, David M Nathan, Jennifer Patricio, Anne Peters, J Bruce Redmon, Rebecca S Reeves, Donna H Ryan, Monika Safford, Brent Van Dorsten, Thomas A Wadden, Lynne Wagenknecht, Jacqueline Wesche-Thobaben, Rena R Wing, Susan Z Yanovski
Abstract
Objective: The effectiveness of intentional weight loss in reducing cardiovascular disease (CVD) events in type 2 diabetes is unknown. This report describes 1-year changes in CVD risk factors in a trial designed to examine the long-term effects of an intensive lifestyle intervention on the incidence of major CVD events.
Research design and methods: This study consisted of a multicentered, randomized, controlled trial of 5,145 individuals with type 2 diabetes, aged 45-74 years, with BMI >25 kg/m2 (>27 kg/m2 if taking insulin). An intensive lifestyle intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity was compared with a diabetes support and education (DSE) condition.
Results: Participants assigned to ILI lost an average 8.6% of their initial weight vs. 0.7% in DSE group (P < 0.001). Mean fitness increased in ILI by 20.9 vs. 5.8% in DSE (P < 0.001). A greater proportion of ILI participants had reductions in diabetes, hypertension, and lipid-lowering medicines. Mean A1C dropped from 7.3 to 6.6% in ILI (P < 0.001) vs. from 7.3 to 7.2% in DSE. Systolic and diastolic pressure, triglycerides, HDL cholesterol, and urine albumin-to-creatinine ratio improved significantly more in ILI than DSE participants (all P < 0.01).
Conclusions: At 1 year, ILI resulted in clinically significant weight loss in people with type 2 diabetes. This was associated with improved diabetes control and CVD risk factors and reduced medicine use in ILI versus DSE. Continued intervention and follow-up will determine whether these changes are maintained and will reduce CVD risk.
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Source: PubMed