Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes
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.
Diabetes Care