Meal replacements are an effective weight loss tool for overweight and obese people with type 2 diabetes, according to the one-year results of the Look AHEAD trial published in the June, 2007 issue of Diabetes Care. The study also suggests that the clinically significant weight loss resulting from following the reduced-calorie diet using meal replacements also resulted in significant improvements in blood glucose, insulin, hemoglobin A1c and lipid levels.1
Objective:
The National Institutes of Health funded Look AHEAD (Action for Health in Diabetes) a multi-centered, randomized, controlled clinical trial of 5,145 overweight or obese individuals with type 2 diabetes. Over a period of 11 ½ years, the trial will examine the effectiveness of an intensive lifestyle intervention on reducing major cardiovascular disease (CVD) events in type 2 diabetes.
Methods:
An intensive lifestyle intervention (ILI) was compared with a diabetes support and education (DSE) method.
The ILI combined dietary modification and increased physical activity (≥ 175 min./week) along with group and individual meetings, and was designed to induce a minimum weight loss of 7% of initial body weight during the first year. Calorie restriction was the primary method of achieving weight loss, and the use of meal replacements played a significant role in the dietary intervention.
The DSE group received an initial session of diabetes education (as did the ILI group) and received usual care. The DSE group was considered the control arm of the study.
One-Year Results :
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Participants assigned to ILI lost an average 8.6% of their initial weight vs. 0.7% in DSE group (P<0.001). |
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One-Year Results (continued):
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Mean fitness increased in ILI by 20.9 vs. 5.8% in DSE (P<0.001). |
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ILI participants had reductions in the use of glucose-lowering medicines as compared with an increase among DSE participants (P<0.001). |
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Mean A1c dropped from 7.3 to 6.6% in the ILI group (P<0.001) vs. from 7.3 to 7.2% in the DSE group. Systolic and diastolic pressure, triglycerides, HDL cholesterol and urine albumin-to-creatinine ratio improved significantly more in ILI than DSE participants (P<0.01). |
CONCLUSION:
At 1 year, ILI resulted in clinically significant weight loss in people with type 2 diabetes. This was associated with improved diabetes control and CVD risk factors and reduced medication use in the ILI versus DSE group. Continued intervention and follow-up will determine whether these changes are maintained and will reduce CVD risk.
Sources:
Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals with Type 2 Diabetes: One-year results of the Look AHEAD trial. The Look AHEAD Research Group. Diabetes Care 2007; 30: 1-10.
The Look AHEAD Study: A description of the lifestyle intervention and the evidence supporting it. The Look AHEAD Research Group, Obesity 2006; 14(5):737-752.
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