Diabetes: Look AHEAD published: Weight loss not linked to fewer cardiovascular events in patients with type 2 diabetes

摘要

At the beginning of the study, the primary end point was defined as the first occurrence of nonfatal myocardial infarction, nonfatal stroke, or death from cardiovascular causes. However, the event rate was lower than expected during the first 2 years of the trial, and so hospitalization for angina was added to the primary end point during the study. In September 2012, the trial sponsors halted the intervention on the basis of a futility analysis and recommendation by the data and safety monitoring board. Median follow-up was 9.6 years. The intensive lifestyle intervention was associated with a mean weight loss of 8.6% at 1 year and 6.0% at the end of the study, compared with 0.7% and 3.5%, respectively, in the control group. Notably, the initial weight loss recorded in the intensive lifestyle intervention group at the 1 -year follow-up was followed by weight regain at years 2-5, and then a gradual weight loss over the last 5 years of the study. By contrast, the (smaller) weight loss in the control group was gradual and consistent over the course of the study. At 1-year follow-up, the intensive lifestyle intervention was associated with lower systolic and diastolic blood pressures, a lower triglyceride level, and a higher HDL-cholesterol level than the control regimen.