- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Study Finds Lifestyle Intervention Aimed at Weight Loss May Reduce Cardiovascular Events in Type 2 Diabetes
Intensive lifestyle intervention focusing on weight loss may reduce cardiovascular events in selected type 2 diabetes patients yet have a detrimental treatment effect in some, according to recent research.
Intensive lifestyle intervention focusing on weight loss may reduce cardiovascular events in selected type 2 diabetes patients yet have a detrimental treatment effect in some, according to recent research.
The study, published by Diabetes Care, investigated the presence of heterogeneity of treatment effect (HTE) of an intensive lifestyle intervention in order to measure the efficacy on the occurrence of major cardiovascular events (MACE) in patients with type 2 diabetes who are also overweight or obese.
The researchers used data from the Action for Health in Diabetes trial and assessed 4901 participants. Additionally, a penalized Cox regression model was utilized to predict the treatment effect of intensive lifestyle intervention for the risk of MACE. Hazard ratios were calculated and the absolute risk change of the predicted treatment effect were used to confirm the model’s efficacy between quartiles, according to the study.
The results revealed that in quartile 1 of predicted treatment effect, with the highest predicted risk reduction, the researchers found that there was a significant treatment benefit of intensive lifestyle intervention (hazard ratio [HR] 0.64; 95% CI 0.49—0.83). However, in quartiles 2 and 3 there was no effect from the treatment. There was a detrimental effect in quartile 4 (HR 1.37; 95% CI 1.09–1.73).
The study also noted that demographics, medical history, physical examination, and laboratory values were associated with the level of treatment effect.
“This post hoc analysis of the Look AHEAD trial showed that an intensive lifestyle intervention aimed at weight loss may reduce cardiovascular events in selected patients but may have a detrimental treatment effect in others,” concluded the authors.
Reference
Vries T, Dorresteijn J, Graaf Y, et al. Heterogeneity of Treatment Effects From an Intensive Lifestyle Weight Loss Intervention on Cardiovascular Events in Patients With Type 2 Diabetes: Data From the Look AHEAD Trial [published online September 2019]. Diabetes Care. doi.org/10.2337/dc19-0776.
Research Points to Potential MCIDs in Diabetes Distress Scale–17
November 29th 2023Researchers identified a value of at least 0.25 to be a minimal clinically important difference (MCID) in diabetes distress, and MCID values of 0.38 and 0.39 for emotional and interpersonal distress subscales and physician and regimen distress subscales, respectively.
Read More
How Can Employers Leverage the DPP to Improve Diabetes Rates?
February 15th 2022On this episode of Managed Care Cast, Jill Hutt, vice president of member services at the Greater Philadelphia Business Coalition on Health, explains the Coalition’s efforts to reduce diabetes rates through the Diabetes Prevention Program (DPP).
Listen
Balancing Care Access and Fragmentation for Better Outcomes in Veterans With Diabetes
April 22nd 2021The authors of a study in the April 2021 issue of The American Journal of Managed Care® discuss the possible reasons behind the link between care fragmentation and hospitalizations in veterans with diabetes, as well as potential opportunities to address disjointed care in the context of the widespread telehealth uptake seen during the COVID-19 pandemic.
Listen
