Author
PI-SUNYER, XAVIER - ST. LUKE'S ROOSEVELT HOSP | |
BLACKBURN, GEORGE - ISRAEL DEACONESS MED CTR | |
BRANCATI, FREDERICK - JOHNS HOPKINS MED INST | |
BRAY, GEORGE - PENNINGTON BIOMED RES CTR | |
BRIGHT, RENEE - MIRIAM HOSP/BROWN MED SCH | |
CLARK, JEANNE - JOHNS HOPKINS MED INST | |
CURTIS, JEFFREY - SOUTHWESTERN AM INDIAN CT | |
ESPELAND, MARK - WAKE FOREST UNIV | |
Foreyt, John | |
GRAVES, KATHRYN - UNIV SOUTHERN CA | |
HAFFNER, STEVEN - UNIV TX HEALTH SCI CTR | |
HARRISON, BARBARA - NIH/NIDDK | |
HILL, JAMES - UNIV CO HEALTH SCI CTR | |
HORTON, EDWARD - JOSLIN DIABETES CENTER | |
JAKICIC, JOHN - MIRIAM HOSP/BROWN MED SCH | |
JEFFERY, ROBERT - UNIV MINNESOTA | |
JOHNSON, KAREN - UNIV TENN HEALTH SCI CTR | |
KAHN, STEVEN - UNIV WASHINGTON | |
KELLEY, DAVID - UNIV PITTSBURGH | |
KITABCHI, ABBAS - UNIV TENN HEALTH SCI CTR | |
KNOWLER, WILLIAM - SOUTHWESTERN AM INDIAN CT | |
LEWIS, CORA - UNIV ALABAMA | |
MASCHAK-CAREY, BARBARA - UNIV PENNSYLVANIA | |
MONTGOMERY, BRENDA - UNIV WASHINGTON | |
NATHAN, DAVID - HARVARD CENTER | |
PATRICIO, JENNIFER - ST LUKE'S ROOSEVELT HOSP | |
PETERS, ANNE - UNIV SOUTHERN CALIFORNIA | |
REDMON, BRUCE - UNIV MINNESOTA | |
REEVES, REBECCA - BAYLOR COLLEGE MED | |
RYAN, DONNA - PENNINGTON BIOMED RES CTR | |
SAFFORD, MONIKA - UNIV ALABAMA | |
VAN DORSTEN, BRENT - UNIV CO HEALTH SCI CTR | |
WADDEN, THOMAS - UNIV PENNSYLVANIA | |
WAGENKNECHT, LYNNE - WAKE FOREST UNIV | |
WESCHE-THOBABEN, JACQUELINE - UNIV PITTSBURGH | |
WING, RENA - MIRIAM HOSP/BROWN MED SCH | |
YANOVSKI, SUSAN - NIH/NIDDK |
Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal Publication Acceptance Date: 3/5/2007 Publication Date: 6/1/2007 Citation: Pi-Sunyer, X., Blackburn, G., Brancati, F.L., Bray, G.A., Bright, R., Clark, J.M., Curtis, J.M., Espeland, M.A., Foreyt, J., Graves, K., Haffner, S.M., Harrison, B., Hill, J.O., Horton, E.S., Jakicic, J., Jeffery, R.W., Johnson, K.C., Kahn, S., Kelley, D.E., Kitabchi, A.E., Knowler, W.C., Lewis, C.E., Maschak-Carey, B.J., Montgomery, B., Nathan, D.M., Patricio, J., Peters, A., Redmon, B., Reeves, R.S., Ryan, D.H., Safford, M., Van Dorsten, B., Wadden, T.A., Wagenknecht, L., Wesche-Thobaben, J., Wing, R.R., Yanovski, S.Z. 2007. Reduction in weight and cardiovascular diasease risk factors in individuals with type 2 diabetes: One-year results of the Look AHEAD trial. Diabetes Care. 30(6):1374-1383. Interpretive Summary: This study examines the long-term effectiveness in reduction in weight and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes. An intensive lifestyle intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical acitivity was compared with a diabetes support and education (DSE) condition. At one year, the results indicated that ILI showed clinically significant weight loss in people. The authors propose that this was due to improved diabetes control and CVD risk factors, as well as reduced medicine use in ILI versus DSE. Technical Abstract: 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. 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. 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). 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. |