Monday, 4 October 2010

Long Term Exercise and Diet on Control of Diabetes vs Ordinary Care

From Archives of Internal Medicine

Vol. 170 No. 17, September 27, 2010

The investigators, from the Look AHEAD (Action for Health in Diabetes) Research Group, carried out a multicenter, randomized clinical trial which compared the effects of an intensive lifestyle intervention versus diabetes support and education. The study involved 5,145 obese/overweight people with diabetes Type 2 - their average age was 58.7 years.

* Lifestyle intervention ( ILI ) group - 2,570 of them were assigned to a combination of special diet and physical activity. The aim was to get them to lose 7% of their body weight within 12 months - and to keep the weight off for a period of four years. They were contacted by phone and/or seen at least once a month throughout the 48-month period.

* Diabetes support group (DSE) - 2,575 of them received diabetes support and education. They were encouraged to attend three group sessions annually - these sessions focused on such themes as diet, social support and physical activity.

The ILI group was successful in producing sustained weight losses and improvements in cardiovascular fitness through 4 years of follow-up. The ILI group also experienced significantly greater improvements than the usual-care (DSE) group in A1c, HDL, and blood pressure averaged across this period. The ILI group in the Look AHEAD trial is being offered ongoing intervention activities in an effort to sustain the improvements in risk factors. Cost-effectiveness analyses are being conducted.

The critical question is whether the differences between groups in risk factors will translate into differences in the development of CVD. These results will not be available for several additional years.

Conclusions: Intensive lifestyle intervention can produce sustained weight loss and improvements in fitness, glycemic control, and CVD risk factors in individuals with type 2 diabetes.