Diabetes Self-Management Blog

Lifestyle changes such as increasing physical activity and eating an improved diet are often touted as some of the most effective ways to manage blood glucose levels. Now a new study has rounded up even more evidence that supports making these adjustments: According to members of the Look AHEAD (Action for Health in Diabetes) research group, intensive lifestyle intervention can reduce cardiovascular risk factors in people with Type 2 diabetes over the long term. Heart disease is the leading cause of death for people with Type 2 diabetes.

Look AHEAD, a multicenter, randomized clinical trial, compared the effects of intensive lifestyle intervention to diabetes support and education on cardiovascular events in over 5,000 overweight or obese people with Type 2 diabetes. Lifestyle intervention consisted of dietary modification and physical activity recommendations reinforced with individual or group visits on a weekly basis for the first six months of the study, three times a month for the second six months, and at least twice a month for years two through four. The diabetes support and education group, serving as the control, was given three group sessions a year that focused on diet, physical activity, and social support.

On average, the lifestyle interventions group had greater improvements in weight, fitness, A1C, systolic blood pressure, diastolic blood pressure, HDL cholesterol, and triglycerides than the control group over the course of the study. More of those in the intervention group were also able to discontinue their diabetes and blood pressure medicines during the study; despite using less medicine, more people in this group met the American Diabetes Association’s goals for A1C and blood pressure.

In a comment on the study, Prakash Deedwania, MD, wrote, “These findings are exciting and provide solid evidence of sustained benefit of simple interventions, such as [therapeutic lifestyle interventions], on multiple important cardiovascular risk factors in type 2 diabetes.”

The question remains as to whether it is feasible to attempt intensive lifestyle interventions on a broad scale beyond the clinical trial setting. Among the obstacles are a nationwide lack of dietitians and health educators and the potential for the interventions to be less successful in people who are not as motivated as those who participated in the trial.

To learn more about the research, see the article “Lifestyle Changes Work Over Long Term in Diabetes” or read the study’s abstract in the Archives of Internal Medicine. And for more about keeping your heart healthy, “click here.

And to learn about the FDA’s recent decision to put restrictions on the sale of diabetes drug Avandia (rosiglitazone), see “Avandia’s Farewell.”

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