Journal Article

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

Haffner, Steven M, Yanovski, Susan Z, Jeffery, Robert W, Hill, James O, Safford, Monika, Kitabchi, Abbas E, Harrison, Barbara, Maschak-Carey, Barbara J, Peters, Anne, Patricio, Jennifer, Pi-Sunyer, Xavier, Foreyt, John P, Knowler, William C, Ryan, Donna H, Espeland, Mark A, Curtis, Jeffrey M, Wadden, Thomas A, Reeves, Rebecca S, Clark, Jeanne M, Horton, Edward S, Blackburn, George, Kahn, Steven, Van Dorsten, Brent, Graves, Kathryn, Kelley, David E, Montgomery, Brenda, Wagenknecht, Lynne, Nathan, David M, Wesche-Thobaben, Jacqueline, Lewis, Cora E, Brancati, Frederick L, Wing, Rena R, Bray, George A, Redmon, J Bruce, Jakicic, John, Johnson, Karen C, Bright, Renee

2007

Overview

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.

• Publisher: American Diabetes Association
• Subject: Aged / Atherosclerosis (general aspects, experimental research) / Biological and medical sciences / Blood and lymphatic vessels / Body Mass Index / Cardiology. Vascular system / Cardiovascular disease / Cardiovascular Diseases - prevention & control / Causes of / Diabetes / Diabetes Mellitus, Type 2 - complications / Diabetes. Impaired glucose tolerance / Diabetics / Diet / Endocrine pancreas. Apud cells (diseases) / Endocrinopathies / Etiopathogenesis. Screening. Investigations. Target tissue resistance / Exercise Test / Follow-Up Studies / Health aspects / Humans / Life Style / Medical research / Medical sciences / Middle Aged / Miscellaneous / Nutrition / Patient Education as Topic / Physical Fitness / Psychological aspects / Public health. Hygiene / Public health. Hygiene-occupational medicine / Risk factors / Self Care / Time Factors / Weight control / Weight Loss