Diabetes / Endocrinology

Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes

Source: The Look AHEAD Research Group. N Engl J Med 2013;369:145-154.

Type 2 diabetes increases risk for cardiovascular events, their frequency and severity, especially when compared to non-diabetic controls. A majority of America’s type 2 diabetics are overweight/obese. Despite exercise and weight-loss being shown to aid in glucose and lipid normalization as well as the diabetic progression, no large clinical trials are confirmed.

In order to further investigate the link between intensive lifestyle change and decreased cardiovascular risk, The Look AHEAD Research Group randomly assigned a total of 5,145 overweight subjects with DM2 to either intensive lifestyle changes or a control. The intensive lifestyle group aimed to cut patients’ weight by more than 7% while also increasingly their weekly moderate-intense exercise totals.

While the trial was initially intended to last for at least 13 years, it was stopped midway through the 10th year, as futility analysis allowed the determination that despite greater weight-loss and improved glycemic control, the intensive lifestyle group was unlikely to receive any possible benefits from their lifestyle changes.

Despite positively affecting DM2 patients’ BMIs and glycemic indexes, drastic lifestyle changes do not appear to improve CV risk.