title: Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.
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.
  
  
  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.
authors.affiliation: St. Luke's Roosevelt Hospital Center, USA.
authors.forename: Xavier
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authors.lastname: Pi-Sunyer
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authors.lastname: Blackburn
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authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Barbara J
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authors.lastname: Maschak-Carey
authors.forename: Brenda
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authors.lastname: Montgomery
authors.forename: David M
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authors.lastname: Nathan
authors.forename: Jennifer
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authors.lastname: Patricio
authors.forename: Anne
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authors.lastname: Peters
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authors.lastname: Redmon
authors.forename: Rebecca S
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authors.lastname: Reeves
authors.forename: Donna H
authors.initials: DH
authors.lastname: Ryan
authors.forename: Monika
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authors.lastname: Safford
authors.forename: Brent
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authors.lastname: Van Dorsten
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Lynne
authors.initials: L
authors.lastname: Wagenknecht
authors.forename: Jacqueline
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authors.lastname: Wesche-Thobaben
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authors.lastname: Wing
authors.forename: Susan Z
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authors.lastname: Yanovski
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005080:Exercise Test; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D010353:Patient Education as Topic; D010809:Physical Fitness; D012648:Self Care; D013997:Time Factors; D015431:Weight Loss