Type 2 diabetes (dm2) is characterized by increased risk for cardiovascular (CV) events, which are not only more frequent but also more severe than similar events in non-diabetics. Most DM2 patients in America are overweight or obese. Weight loss and exercise have been shown to improve glucose control, lipids, blood pressure, and progression from pre-diabetes to diabetes, but no large clinical trials have confirmed risk reduction for CV events attributable to lifestyle intervention.
The Look AHEAD trial randomized overweight or obese DM2 patients (n = 5145) to intensive lifestyle or control (the control group still received education and support in reference to care of their DM2). The goal of intensive lifestyle was to reduce weight by at least 7% and participate in at least 175 minutes/week of moderate-intensity physical activity.
The trial was originally intended to go on for 13.5 years, but was stopped early (at 9.6 years) because futility analysis demonstrated no likely possible benefit of the intensive intervention for CV events compared to controls, despite greater weight loss and improved glycemic control attained in the intensive lifestyle group.
Intensive lifestyle intervention in DM2 improves glycemic indices and body mass index, but does not appear to improve CV risk.
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