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.

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.