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Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial.
Diabetes Care 2007; 30(6):1374-83DC

Abstract

OBJECTIVE

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.

RESEARCH DESIGN AND METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

Authors+Show Affiliations

St. Luke's Roosevelt Hospital Center, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

17363746

Citation

Look AHEAD Research Group, et al. "Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes: One-year Results of the Look AHEAD Trial." Diabetes Care, vol. 30, no. 6, 2007, pp. 1374-83.
Look AHEAD Research Group, Pi-Sunyer X, Blackburn G, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care. 2007;30(6):1374-83.
Pi-Sunyer, X., Blackburn, G., Brancati, F. L., Bray, G. A., Bright, R., Clark, J. M., ... Yanovski, S. Z. (2007). Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. Diabetes Care, 30(6), pp. 1374-83.
Look AHEAD Research Group, et al. Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes: One-year Results of the Look AHEAD Trial. Diabetes Care. 2007;30(6):1374-83. PubMed PMID: 17363746.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the look AHEAD trial. AU - ,, AU - Pi-Sunyer,Xavier, AU - Blackburn,George, AU - Brancati,Frederick L, AU - Bray,George A, AU - Bright,Renee, AU - Clark,Jeanne M, AU - Curtis,Jeffrey M, AU - Espeland,Mark A, AU - Foreyt,John P, AU - Graves,Kathryn, AU - Haffner,Steven M, AU - Harrison,Barbara, AU - Hill,James O, AU - Horton,Edward S, AU - Jakicic,John, AU - Jeffery,Robert W, AU - Johnson,Karen C, AU - Kahn,Steven, AU - Kelley,David E, AU - Kitabchi,Abbas E, AU - Knowler,William C, AU - Lewis,Cora E, AU - Maschak-Carey,Barbara J, AU - Montgomery,Brenda, AU - Nathan,David M, AU - Patricio,Jennifer, AU - Peters,Anne, AU - Redmon,J Bruce, AU - Reeves,Rebecca S, AU - Ryan,Donna H, AU - Safford,Monika, AU - Van Dorsten,Brent, AU - Wadden,Thomas A, AU - Wagenknecht,Lynne, AU - Wesche-Thobaben,Jacqueline, AU - Wing,Rena R, AU - Yanovski,Susan Z, Y1 - 2007/03/15/ PY - 2007/3/17/pubmed PY - 2007/6/15/medline PY - 2007/3/17/entrez SP - 1374 EP - 83 JF - Diabetes care JO - Diabetes Care VL - 30 IS - 6 N2 - OBJECTIVE: 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. RESEARCH DESIGN AND METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/17363746/Reduction_in_weight_and_cardiovascular_disease_risk_factors_in_individuals_with_type_2_diabetes:_one_year_results_of_the_look_AHEAD_trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=17363746 DB - PRIME DP - Unbound Medicine ER -