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United States Department of Agriculture

Agricultural Research Service

Title: Reduction in weight and cardiovascular diasease risk factors in individuals with type 2 diabetes: One-year results of the Look AHEAD trial

Authors
item Pi-Sunyer, Xavier - ST. LUKE'S ROOSEVELT HOSP
item Blackburn, George - ISRAEL DEACONESS MED CTR
item Brancati, Frederick - JOHNS HOPKINS MED INST
item Bray, George - PENNINGTON BIOMED RES CTR
item Bright, Renee - MIRIAM HOSP/BROWN MED SCH
item Clark, Jeanne - JOHNS HOPKINS MED INST
item Curtis, Jeffrey - SOUTHWESTERN AM INDIAN CT
item Espeland, Mark - WAKE FOREST UNIV
item FOREYT, JOHN
item Graves, Kathryn - UNIV SOUTHERN CA
item Haffner, Steven - UNIV TX HEALTH SCI CTR
item Harrison, Barbara - NIH/NIDDK
item Hill, James - UNIV CO HEALTH SCI CTR
item Horton, Edward - JOSLIN DIABETES CENTER
item Jakicic, John - MIRIAM HOSP/BROWN MED SCH
item Jeffery, Robert - UNIV MINNESOTA
item Johnson, Karen - UNIV TENN HEALTH SCI CTR
item Kahn, Steven - UNIV WASHINGTON
item Kelley, David - UNIV PITTSBURGH
item Kitabchi, Abbas - UNIV TENN HEALTH SCI CTR
item Knowler, William - SOUTHWESTERN AM INDIAN CT
item Lewis, Cora - UNIV ALABAMA
item Maschak-Carey, Barbara - UNIV PENNSYLVANIA
item Montgomery, Brenda - UNIV WASHINGTON
item Nathan, David - HARVARD CENTER
item Patricio, Jennifer - ST LUKE'S ROOSEVELT HOSP
item Peters, Anne - UNIV SOUTHERN CALIFORNIA
item Redmon, Bruce - UNIV MINNESOTA
item Reeves, Rebecca - BAYLOR COLLEGE MED
item Ryan, Donna - PENNINGTON BIOMED RES CTR
item Safford, Monika - UNIV ALABAMA
item Van Dorsten, Brent - UNIV CO HEALTH SCI CTR
item Wadden, Thomas - UNIV PENNSYLVANIA
item Wagenknecht, Lynne - WAKE FOREST UNIV
item Wesche-Thobaben, Jacqueline - UNIV PITTSBURGH
item Wing, Rena - MIRIAM HOSP/BROWN MED SCH
item Yanovski, Susan - NIH/NIDDK

Submitted to: Diabetes Care
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: March 5, 2007
Publication Date: June 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.

Last Modified: 8/19/2014
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