Intensive lifestyle advice ‘improves fitness in diabetes patients’

By Alisdair Stirling

Intensive lifestyle intervention can produce sustained weight loss and improvements in fitness, glycaemic control and CVD risk factors in patients with type 2 diabetes, a new study suggests.

US researchers compared the effects in 2,570 patients offered intensive lifestyle intervention - portion-control, a low-fat and high-protein diet modification, and at least 175 minutes of physical activity a week – and 2,575 controls who received diabetes support and education only.

Averaged across four years, patients in the intervention group had a 5% greater weight loss and greater improvements in treadmill fitness at 12.74% compared with 1.96%.

HbA1c level fell more in those with lifestyle interventions at 0.36% compared with 0.09%, as did systolic blood pressure at 5.33 compared with 2.97mm Hg and diastolic blood pressure, which fell by 2.92 compared with 2.48mm Hg. HDL-cholesterol also fell more, by 3.67% compared with 1.97%. Higher levels of all these markers were maintained in the treatment group after four years.

Study leader Dr Rena Wing, a researcher in psychiatry and human behaviour at Brown University said: ‘Intensive lifestyle intervention can produce improvements in CVD risk factors but whether these differences in risk factors translate into reduction in CVD events is unknown.'

Arch Intern Med 2010;170(17):1566-1575