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Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial.
Diabetes Care 2014; 37(6):1544-53DC

Abstract

OBJECTIVE

We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1-4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores.

RESULTS

ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75-0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores.

CONCLUSIONS

ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs.

Authors

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Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

24855155

Citation

Rubin, Richard R., et al. "Impact of Intensive Lifestyle Intervention On Depression and Health-related Quality of Life in Type 2 Diabetes: the Look AHEAD Trial." Diabetes Care, vol. 37, no. 6, 2014, pp. 1544-53.
Rubin RR, Wadden TA, Bahnson JL, et al. Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial. Diabetes Care. 2014;37(6):1544-53.
Rubin, R. R., Wadden, T. A., Bahnson, J. L., Blackburn, G. L., Brancati, F. L., Bray, G. A., ... Zhang, P. (2014). Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial. Diabetes Care, 37(6), pp. 1544-53. doi:10.2337/dc13-1928.
Rubin RR, et al. Impact of Intensive Lifestyle Intervention On Depression and Health-related Quality of Life in Type 2 Diabetes: the Look AHEAD Trial. Diabetes Care. 2014;37(6):1544-53. PubMed PMID: 24855155.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial. AU - Rubin,Richard R, AU - Wadden,Thomas A, AU - Bahnson,Judy L, AU - Blackburn,George L, AU - Brancati,Frederick L, AU - Bray,George A, AU - Coday,Mace, AU - Crow,Scott J, AU - Curtis,Jeffrey M, AU - Dutton,Gareth, AU - Egan,Caitlin, AU - Evans,Mary, AU - Ewing,Lin, AU - Faulconbridge,Lucy, AU - Foreyt,John, AU - Gaussoin,Sarah A, AU - Gregg,Edward W, AU - Hazuda,Helen P, AU - Hill,James O, AU - Horton,Edward S, AU - Hubbard,Van S, AU - Jakicic,John M, AU - Jeffery,Robert W, AU - Johnson,Karen C, AU - Kahn,Steven E, AU - Knowler,William C, AU - Lang,Wei, AU - Lewis,Cora E, AU - Montez,Maria G, AU - Murillo,Anne, AU - Nathan,David M, AU - Patricio,Jennifer, AU - Peters,Anne, AU - Pi-Sunyer,Xavier, AU - Pownall,Henry, AU - Rejeski,W Jack, AU - Rosenthal,Renate H, AU - Ruelas,Valerie, AU - Toledo,Katie, AU - Van Dorsten,Brent, AU - Vitolins,Mara, AU - Williamson,Donald, AU - Wing,Rina R, AU - Yanovski,Susan Z, AU - Zhang,Ping, AU - ,, PY - 2014/5/24/entrez PY - 2014/5/24/pubmed PY - 2014/12/17/medline SP - 1544 EP - 53 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 6 N2 - OBJECTIVE: We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS: Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1-4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores. RESULTS: ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75-0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores. CONCLUSIONS: ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/24855155/Impact_of_intensive_lifestyle_intervention_on_depression_and_health_related_quality_of_life_in_type_2_diabetes:_the_Look_AHEAD_Trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=24855155 DB - PRIME DP - Unbound Medicine ER -