Life-style intervention for individuals with DM type 2

January 01, 0001

Life-style intervention for individuals with DM type 2

These US authors examined the effects of lifestyle intervention on changes in weight, fitness, and CVD risk factors during a 4-year study. 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 cardiovascular disease 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.

They found: "Averaged across 4 years, ILI participants had a greater percentage of weight loss than DSE participants (-6.15% vs -0.88%) and greater improvements in treadmill fitness (12.74% vs 1.96%), hemoglobin A1c level (-0.36% vs -0.09%), systolic (-5.33 vs -2.97 mm Hg) and diastolic (-2.92 vs -2.48 mm Hg) blood pressure, and levels of high-density lipoprotein cholesterol (3.67 vs 1.97 mg/dL) and triglycerides (-25.56 vs -19.75 mg/dL). Reductions in low-density lipoprotein cholesterol levels were greater in DSE than ILI participants (-11.27 vs -12.84 mg/dL) 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 A1c levels, systolic blood pressure, and high-density lipoprotein cholesterol levels."

The authors concluded: "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."

These early results look promising.

For the full abstract, click here.

Arch Intern Med 170(17):1566-1575, 27 September 2010
© 2010 to the American Medical Association
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. The Look AHEAD Research Group. Correspondence to Rena R. Wing:

Category: T. Endocrine/Metabolic/Nutritional. Keywords: diabetes mellitus type 2, lifestyle modification, weight loss, fitness, cardiovascular disease, glycohemoglobin, cholesterol, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 19 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.