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Randomized Controlled Trial
. 2014 Sep;37(9):2548-56.
doi: 10.2337/dc14-0093.

Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes

Mark A Espeland  1 , Henry A Glick  2 , Alain Bertoni  3 , Frederick L Brancati  4 , George A Bray  5 , Jeanne M Clark  4 , Jeffrey M Curtis  6 , Caitlin Egan  7 , Mary Evans  8 , John P Foreyt  9 , Siran Ghazarian  10 , Edward W Gregg  11 , Helen P Hazuda  12 , James O Hill  13 , Don Hire  14 , Edward S Horton  15 , Van S Hubbard  8 , John M Jakicic  16 , Robert W Jeffery  17 , Karen C Johnson  18 , Steven E Kahn  19 , Tina Killean  6 , Abbas E Kitabchi  18 , William C Knowler  6 , Andrea Kriska  16 , Cora E Lewis  20 , Marsha Miller  13 , Maria G Montez  12 , Anne Murillo  19 , David M Nathan  21 , Ebenezer Nyenwe  18 , Jennifer Patricio  22 , Anne L Peters  10 , Xavier Pi-Sunyer  22 , Henry Pownall  9 , J Bruce Redmon  17 , Julia Rushing  14 , Donna H Ryan  5 , Monika Safford  20 , Adam G Tsai  23 , Thomas A Wadden  2 , Rena R Wing  7 , Susan Z Yanovski  8 , Ping Zhang  11 ; Look AHEAD Research Group
Affiliations
Randomized Controlled Trial

Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes

Mark A Espeland et al. Diabetes Care. 2014 Sep.

Abstract

Objective: To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial.

Research design and methods: A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years.

Results: ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P < 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P < 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385-7,175); however, these were not evident among individuals with a history of cardiovascular disease.

Conclusions: Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs.

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Figures

Figure 1
Figure 1
Per-participant average 10-year cumulative discounted costs. A: Ten-year cumulative total costs. B: Ten-year cumulative medication costs. C: Ten-year cumulative hospitalization costs. D: Ten-year cumulative outpatient care costs. Costs are reported in 2012 U.S. dollars and discounted at 3% per year.
See this image and copyright information in PMC

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