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Randomized Controlled Trial
. 2007 Jun;30(6):1374-83.
doi: 10.2337/dc07-0048. Epub 2007 Mar 15.

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

Look AHEAD Research Group  1 ; Xavier Pi-Sunyer, George Blackburn, Frederick L Brancati, George A Bray, Renee Bright, Jeanne M Clark, Jeffrey M Curtis, Mark A Espeland, John P Foreyt, Kathryn Graves, Steven M Haffner, Barbara Harrison, James O Hill, Edward S Horton, John Jakicic, Robert W Jeffery, Karen C Johnson, Steven Kahn, David E Kelley, Abbas E Kitabchi, William C Knowler, Cora E Lewis, Barbara J Maschak-Carey, Brenda Montgomery, David M Nathan, Jennifer Patricio, Anne Peters, J Bruce Redmon, Rebecca S Reeves, Donna H Ryan, Monika Safford, Brent Van Dorsten, Thomas A Wadden, Lynne Wagenknecht, Jacqueline Wesche-Thobaben, Rena R Wing, Susan Z Yanovski
Affiliations
Randomized Controlled Trial

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

Look AHEAD Research Group et al. Diabetes Care. 2007 Jun.

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.

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Figures

FIGURE 1
FIGURE 1
Enrollment of Look AHEAD participants.
FIGURE 2
FIGURE 2
Distribution of one-year changes in percent weight and fitness (METS) among individuals grouped by intervention assignment. Dashed lines are used to indicate the percentages of ILI participants with weight losses exceeding 10%, 7%, and 5%, respectively.
FIGURE 2
FIGURE 2
Distribution of one-year changes in percent weight and fitness (METS) among individuals grouped by intervention assignment. Dashed lines are used to indicate the percentages of ILI participants with weight losses exceeding 10%, 7%, and 5%, respectively.
See this image and copyright information in PMC

Comment in

References

    1. The Look AHEAD Research Group. Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Cont Clin Trials. 2003;24:610–628. - PubMed
    1. The Look AHEAD Research Group. Baseline characteristics of the randomized cohort from the Look AHEAD (Action for Health in Diabetes) Research Study. Diabetes Vasc Dis Res. 2006;3:202–215. - PMC - PubMed
    1. The Look AHEAD Research Group. The Look AHEAD study: A description of the lifestyle intervention and the evidence supporting it. Obesity. 2006;14:737–752. - PMC - PubMed
    1. Borg GA. Perceived exertion. Exerc Sport Sci Rev. 1974;2:131–153. - PubMed
    1. American College of Sports Medicine. Guidelines for exercise testing and prescription. Philadelphia, PA: Williams and Wilkins; 2005.

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