We don’t usually include individual studies in diabetes because there are so many of them. However, a new report of the Look AHEAD trial, published in the New England Journal of Medicine, points towards significant potential benefits from an intensive lifestyle intervention for people suffering from obesity and type 2 diabetes.
In overweight or obese people with type 2 diabetes, does an intensive lifestyle intervention, as compared to usual care, lead to improvements in mobility?
5145 participants were randomly assigned to receive either an intensive lifestyle intervention or a control group (who received a diabetes support and education programme). They were followed up for four years, with annual assessments of their mobility.
The researchers found that the patients in the lifestyle intervention were less likely to experience severe disability, and more likely to have good mobility than those in the control group.
|Outcome||Time to Outcome||Control||Lifestyle||RRR||ARR||NNT|
|Severe disability||4 years||0.262||0.206||21%||0.056||18|
|95% Confidence Intervals:||12% to 30%||0.033 to 0.079||13 to 31|
|Good mobility||4 years||0.319||0.385||-21%||-0.066||-15|
|95% Confidence Intervals:||-29% to -12%||-0.092 to -0.040||-25 to -11|
- RRR = Relative Risk Reduction
ARR = Absolute Risk Reduction
NNT = Number Needed to Treat
Weight loss and improved fitness slowed the decline in mobility in overweight adults with type 2 diabetes
- Was the treatment allocation concealed from the people who were recruiting patients?
- Could the results be down to co-interventions?
- This trial could not be blinded.
- Could the self-reports of mobility be subject to bias? What other outcomes are important here?
- Could the intervention be delivered in your setting in the same way? See below to access the full protocol of trial and details of the intervention.
Rejeski WJ, Ip EH, Bertoni AG, Bray GA, Evans G, Gregg EW, Zhang Q; Look AHEAD Research Group. Lifestyle change and mobility in obese adults with type 2 diabetes. N Engl J Med. 2012 Mar 29;366(13):1209-17.