Study Finds Lifestyle Intervention Improves Risk Factors in Type 2 Diabetes

An intensive lifestyle intervention created to help participants lose weight and keep it off improves diabetes control, as well as heart disease and stroke risks, in overweight and obese individuals with type 2 diabetes. These improvements are shown in the four-year results of the Look AHEAD (Action for Health in Diabetes) study funded by the NIH and the Centers for Disease Control and Prevention. The results are published in the September 27, 2010, issue of the Archives of Internal Medicine.

This multi-center, randomized clinical trial is unique in that it examines intervention effects over the long term. Researchers from 16 centers across the United States randomly assigned a total of 5,145 participants to an intensive lifestyle intervention or a diabetes support and education program (DSE).

At the time of enrollment, participants were between 45 and 76 years of age, and their mean body mass index (BMI) was 36. (BMI is a measurement of weight in relation to height.) Thirty-seven percent of participants were from racial and ethnic minority groups, and approximately 60 percent were women. About 94 percent of participants remain involved after 4 years and will continue to be followed for up to 13.5 years.

Participants in the ongoing intensive lifestyle intervention attend individual and group meetings and regularly communicate with a lifestyle counselor. Working with this lifestyle counselor, participants learn behavioral skills, such as problem-solving and goal-setting. Participants set specific diet and exercise goals and are encouraged to track their progress through a diet and exercise diary.

In comparison, the DSE group is invited to three group sessions each year focused on diet, physical activity, or social support, but they are not weighed or counseled on behavioral strategies.

When compared across the 4 years, participants in the intervention group, on average, lost more weight (6.2 percent of initial body weight, compared with only 0.9 percent in the DSE group). The intervention group also experienced greater increases in good cholesterol, greater improvement in blood pressure and treadmill fitness, and better control of blood sugar. This is an ongoing study, so continued follow-up will determine whether these improvements are sustained and whether the lifestyle intervention leads to less cardiovascular disease and death. Full results will not be available for several years.