Study: Intensive Lifestyle Intervention More Effective in Type 2 Diabetes than Diabetes Support and Education

Intensive lifestyle intervention (ILI) produces greater improvements in weight, fitness, glycemic control, and cardiovascular (CV) risk factors in patients with Type 2 Diabetes than Diabetes support and education (DSE), revealed the Look AHEAD study. Main objective of the study was to compare the effects of ILI with DSE on lifestyle factors in Type 2 Diabetes patients.

Study

Conducted by Rena Wing from Brown Medical School, Providence, Rhode Island, USA, and her team. Rena said, “The critical question is whether the differences between groups in risk factors will translate into differences in the development of cardiovascular disease. These results will not be available for several additional years. However, effects of the magnitude that we observed for fitness, high-density lipoprotein (HDL) cholesterol and glycated hemoglobin (HbA1c) levels, and blood pressure have been associated with decreased CV events and mortality in previous medication trials and observational studies."

Findings: 

• Over the period of 4 years, the mean percentage of weight loss was greater at 6.15% in ILI group as compared to 0.88% in DSE group
• Treadmill fitness: A significant improvement in ILI group was seen at 12.74% as compared to 1.96% of the DSE group 
• HbA1c: A significant improvement in ILI group was seen at 0.36% as compared to 0.09% of the DSE group
• ILI group witnessed a significant decrease in systolic and diastolic blood pressure than DSE patients, by 5.33 versus 2.97 mmHg and 2.92 versus 2.48 mmHg, respectively
• HDL cholesterol increased and triglycerides decreased to a greater extent in ILI than DSE patients, by 3.67 versus 1.97 mg/dl and 25.56 versus 19.75 mg/dl, respectively
• Low-density lipoprotein cholesterol reductions were greater in DSE than ILI patients, by 12.84 versus 11.27 mg/dl.

Rena concluded, “Longer follow-up will allow us to determine whether the differences between groups in CV disease risk factors can be maintained and whether the ILI has positive effects on CV morbidity and mortality.”

The DSE group is given dietary advice and recommendations to increase physical activity while the ILI group has to attend weekly group sessions and monthly individual sessions with a lifestyle counselor.