(17-10-10) Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus

four-year results of the Look AHEAD trial.

Look AHEAD Research Group, Wing RR.

Collaborators (435)
Department of Psychiatry, The Miriam Hospital/Brown Medical School,
Providence, RI 02860, USA. [email protected]
Comment in:

Arch Intern Med. 2010 Sep 27;170(17):1575-7.
Abstract
BACKGROUND: Lifestyle interventions produce short-term improvements in
glycemia and cardiovascular disease (CVD) risk factors in individuals with type
2 diabetes mellitus, but no long-term data are available. We examined the
effects of lifestyle intervention on changes in weight, fitness, and CVD risk
factors during a 4-year study.

METHODS: The Look AHEAD (Action for Health in Diabetes) trial is a multicenter
randomized clinical trial comparing the effects of an intensive lifestyle
intervention (ILI) and diabetes support and education (DSE; the control group)
on the incidence of major CVD events in 5145 overweight or obese individuals
(59.5% female; mean age, 58.7 years) with type 2 diabetes mellitus. More than
93% of participants provided outcomes data at each annual assessment.

RESULTS: Averaged across 4 years, ILI participants had a greater percentage of
weight loss than DSE participants (-6.15% vs -0.88%; P < .001) and greater
improvements in treadmill fitness (12.74% vs 1.96%; P < .001), hemoglobin A(1c)
level (-0.36% vs -0.09%; P < .001), systolic (-5.33 vs -2.97 mm Hg; P < .001)
and diastolic (-2.92 vs -2.48 mm Hg; P = .01) blood pressure, and levels of
high-density lipoprotein cholesterol (3.67 vs 1.97 mg/dL; P < .001) and
triglycerides (-25.56 vs -19.75 mg/dL; P < .001). Reductions in low-density
lipoprotein cholesterol levels were greater in DSE than ILI participants
(-11.27 vs -12.84 mg/dL; P = .009) owing to greater use of medications to lower
lipid levels in the DSE group. At 4 years, ILI participants maintained greater
improvements than DSE participants in weight, fitness, hemoglobin A(1c) levels,
systolic blood pressure, and high-density lipoprotein cholesterol levels.

CONCLUSIONS: Intensive lifestyle intervention can produce sustained weight
loss and improvements in fitness, glycemic control, and CVD risk factors in
individuals with type 2 diabetes. Whether these differences in risk factors
translate to reduction in CVD events will ultimately be addressed by the Look
AHEAD trial.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00017953.

Source: Arch Intern Med. 2010 Sep 27;170(17):1566-75.

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.