Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.
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.
St. Luke's Roosevelt Hospital Center, USA.
Pi-Sunyer
Xavier
X
Blackburn
George
G
Brancati
Frederick L
FL
Bray
George A
GA
Bright
Renee
R
Clark
Jeanne M
JM
Curtis
Jeffrey M
JM
Espeland
Mark A
MA
Foreyt
John P
JP
Graves
Kathryn
K
Haffner
Steven M
SM
Harrison
Barbara
B
Hill
James O
JO
Horton
Edward S
ES
Jakicic
John
J
Jeffery
Robert W
RW
Johnson
Karen C
KC
Kahn
Steven
S
Kelley
David E
DE
Kitabchi
Abbas E
AE
Knowler
William C
WC
Lewis
Cora E
CE
Maschak-Carey
Barbara J
BJ
Montgomery
Brenda
B
Nathan
David M
DM
Patricio
Jennifer
J
Peters
Anne
A
Redmon
J Bruce
JB
Reeves
Rebecca S
RS
Ryan
Donna H
DH
Safford
Monika
M
Van Dorsten
Brent
B
Wadden
Thomas A
TA
Wagenknecht
Lynne
L
Wesche-Thobaben
Jacqueline
J
Wing
Rena R
RR
Yanovski
Susan Z
SZ
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