PMID- 25936906
OWN - NLM
STAT- MEDLINE
DCOM- 20150908
LR  - 20220310
IS  - 1873-1740 (Electronic)
IS  - 0033-0620 (Print)
IS  - 0033-0620 (Linking)
VI  - 58
IP  - 1
DP  - 2015 Jul-Aug
TI  - The Look AHEAD Trial: Implications for Lifestyle Intervention in Type 2 Diabetes 
      Mellitus.
PG  - 69-75
LID - S0033-0620(15)00027-4 [pii]
LID - 10.1016/j.pcad.2015.04.002 [doi]
AB  - Given the array of adverse health consequences of obesity, including increased 
      risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the 
      Look AHEAD trial (N=5145) was conducted to test the hypothesis that an intensive 
      lifestyle intervention (ILI) for weight loss would achieve significantly greater 
      reductions in CVD morbidity and mortality than a control condition of diabetes 
      support and education (DSE) among participants with T2DM. A number of significant 
      and long-term improvements were observed for ILI, including body weight, physical 
      fitness and physical function, glucose control, quality-of-life (QoL), and 
      healthcare costs. However, ILI did not significantly reduce CVD-related 
      morbidity/mortality (i.e., CVD death, non-fatal MI, non-fatal stroke, 
      hospitalized angina) after nearly 10 years of follow-up. There was a suggestion 
      of heterogeneity of response based on the history of prior CVD at baseline 
      (p=0.06). Despite the overall lack of CVD risk reduction, ILI remains important 
      for care of patients with T2DM, particularly when accompanied by medication 
      management. In particular, ILI may be an appealing option for patients wanting to 
      minimize medication intensification. Also, ILI carries with it other potential 
      benefits important to patients (e.g., improvements in physical functioning and 
      QoL). Based on data from other trials, intensive medication management, such as 
      tight glycemic control, is not without potential risks, which should be weighed 
      in making treatment decisions. Future research is needed to determine if results 
      observed in this trial would be replicated among younger patients, those without 
      established T2DM, and/or those with no pre-existing CVD.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Dutton, Gareth R
AU  - Dutton GR
AD  - Division of Preventive Medicine, Department of Medicine, School of Medicine and 
      Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL.
FAU - Lewis, Cora E
AU  - Lewis CE
AD  - Division of Preventive Medicine, Department of Medicine, School of Medicine and 
      Diabetes Research Center, University of Alabama at Birmingham, Birmingham, AL. 
      Electronic address: celewis@uabmc.edu.
LA  - eng
GR  - K23 DK081607/DK/NIDDK NIH HHS/United States
GR  - DK081607/DK/NIDDK NIH HHS/United States
GR  - P30 DK079626/DK/NIDDK NIH HHS/United States
GR  - P60 DK079626/DK/NIDDK NIH HHS/United States
GR  - UL1 RR025758/RR/NCRR NIH HHS/United States
GR  - DK079626/DK/NIDDK NIH HHS/United States
GR  - U01 DK057008/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Review
DEP - 20150430
PL  - United States
TA  - Prog Cardiovasc Dis
JT  - Progress in cardiovascular diseases
JID - 0376442
SB  - IM
MH  - Adiposity
MH  - Cardiovascular Diseases/diagnosis/mortality/*prevention & control
MH  - Diabetes Mellitus, Type 2/diagnosis/mortality/*therapy
MH  - *Diet/adverse effects
MH  - Evidence-Based Medicine
MH  - *Exercise
MH  - Health Status
MH  - Humans
MH  - Obesity/diagnosis/mortality/*therapy
MH  - Preventive Health Services/*methods
MH  - Protective Factors
MH  - Randomized Controlled Trials as Topic
MH  - Risk Assessment
MH  - Risk Factors
MH  - *Risk Reduction Behavior
MH  - Time Factors
MH  - Treatment Outcome
MH  - Weight Loss
PMC - PMC4501472
MID - NIHMS686302
OTO - NOTNLM
OT  - Cardiovascular disease
OT  - Lifestyle intervention
OT  - Type 2 diabetes mellitus
OT  - Weight loss
COIS- Conflict of Interest: Dr. Lewis receives research grant support for her role as 
      Principal Investigator (paid to the University of Alabama at Birmingham) from 
      Novo Nordisk
EDAT- 2015/05/06 06:00
MHDA- 2015/09/09 06:00
PMCR- 2016/07/01
CRDT- 2015/05/05 06:00
PHST- 2015/05/05 06:00 [entrez]
PHST- 2015/05/06 06:00 [pubmed]
PHST- 2015/09/09 06:00 [medline]
PHST- 2016/07/01 00:00 [pmc-release]
AID - S0033-0620(15)00027-4 [pii]
AID - 10.1016/j.pcad.2015.04.002 [doi]
PST - ppublish
SO  - Prog Cardiovasc Dis. 2015 Jul-Aug;58(1):69-75. doi: 10.1016/j.pcad.2015.04.002. 
      Epub 2015 Apr 30.