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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)

Author
item Pi-sunyer, Xavier
item Blackburn, George
item Brancati, Frederick
item Bray, George
item Bright, Renee
item Clark, Jeanne
item Curtis, Jeffrey
item Espeland, Mark
item Foreyt, John
item Graves, Kathryn
item Haffner, Steven
item Harrison, Barbara
item Hill, James
item Horton, Edward
item Jakicic, John
item Jeffery, Robert
item Johnson, Karen
item Kahn, Steven
item Kelley, David
item Kitabchi, Abbas
item Knowler, William
item Lewis, Cora
item Maschak-carey, Barbara
item Montgomery, Brenda
item Nathan, David
item Patricio, Jennifer
item Peters, Anne
item Redmon, Bruce
item Reeves, Rebecca
item Ryan, Donna
item Safford, Monika
item Van Dorsten, Brent
item Wadden, Thomas
item Wagenknecht, Lynne
item Wesche-thobaben, Jacqueline
item Wing, Rena
item Yanovski, Susan

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.

Last Modified: 8/24/2016
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