title: Impact of intensive lifestyle intervention on preference-based quality of life in type 2 diabetes: Results from the Look AHEAD trial.
abstract: OBJECTIVE
  To assess the effect of an intensive lifestyle intervention (ILI) compared with standard diabetes support and education (DSE) on preference-based health-related quality of life (HRQOL) in persons with overweight or obesity and type 2 diabetes.
  
  
  METHODS
  Look AHEAD was a multisite, randomized trial of 5,145 participants assigned to ILI or DSE. Four instruments were administered during the trial: Feeling Thermometer (FT), Health Utilities Index Mark 2 (HUI2), Health Utilities Index Mark 3 (HUI3), and Short Form 6D (SF-6D). Linear mixed effect models were used to estimate the mean difference in preference scores by treatment group for 9 years.
  
  
  RESULTS
  The ILI had higher mean FT (0.019, 95% CI, 0.015-0.024, P < 0.001) and SF-6D (0.011, 95% CI, 0.006-0.014, P < 0.001) scores than the DSE. No significant group differences were observed for the HUI2 (0.004, 95% CI, -0.003 to 0.010, P = 0.23) and HUI3 (0.004, -0.004 to 0.012, P = 0.36). In year 1, the ILI had higher mean preference scores for all instruments. Thereafter, the increases remained significant only for FT and SF-6D, and the effects also become smaller.
  
  
  CONCLUSIONS
  ILI aimed at reducing body weight among persons with overweight or obesity and type 2 diabetes improves preference-based HRQOL in the short term, but its long-term effect is unclear.
authors.affiliation: Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Hire
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA.
authors.forename: William C
authors.initials: WC
authors.lastname: Knowler
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Sheikilya
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Division of Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Tsai
authors.affiliation: Division of General Internal Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Henry A
authors.initials: HA
authors.lastname: Glick
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000628:therapy; D050177:Overweight / Q000523:psychology* / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods; D057240:Patient Preference; D011788:Quality of Life; D015431:Weight Loss