The Look AHEAD trial has found that weight loss accomplished by a proper diet and exercise does not help in reducing heart problems in obese or overweight patients with type 2 diabetes.
The Look AHEAD trial, sponsored by the National Institutes of Health (NIH) conducted a study to determine the benefits of weight loss in reducing heart problems in people with type 2 diabetes. The findings of the trial were presented online in the American Diabetes Association website.
The trial looked at 5,145 people with type 2 diabetes who were randomly divided into two groups. The first group underwent an intensive lifestyle intervention, focusing on weight loss through a low-calorie diet and increased exercise while the other group was put under conventional diabetes care.
Investigators planned on running the trial for 13.5 years wherein they hoped to find a significant difference in the rate of major cardiovascular events. Unfortunately, last September, after the trial completed 9.6 years of following up the data, the trial was stopped for futility.
During the trial, 418 people from the second group experienced major cardiovascular events compared to 403 people from the first group revealed a report published online in the New England Journal of Medicine.
However, Mary Evans, PhD, director of Look AHEAD at the National Institute of Diabetes and Digestive and Kidney Diseases did reveal that people from the first group that underwent a lifestyle intervention did benefit in other ways.
"They sustained 6% weight loss over 10 years. They had clinically meaningful improvements in glycated hemoglobin levels and less diabetes and less retinopathy. There were also improvements in quality of life and reduction in depression," she said.
Evans notes that the reason why there wasn't any significant difference in the results regarding reduction in heart problems was probably because people under conventional diabetes care consumed more medication than people from the first group.
"The drugs, particularly statins, could have lowered their risk of cardiovascular disease. Or perhaps people in the intervention group didn't achieve enough weight loss," she said.
The adverse effects including the rate of self-reported fractures were significantly higher among patients in the first group (lifestyle intervention) but there was no significant difference in the rate of adjudicated fractures.
A major drawback of the study, researchers noted, was the fact that people recruited for the study included people who were interested in losing weight and so authors are not sure whether the findings of this study are applicable across also overweight, diabetic patients.
"Even with no clear evidence of cardiovascular benefit, the Look AHEAD investigators have shown that attention to activity and diet can safely reduce the burden of diabetes and have reaffirmed the importance of lifestyle approaches as one of the foundations of modern diabetes care," Hertzel Gerstein, MD, University of Hamilton in Ontario in Canada, wrote in an accompanying editorial.
