Citation: The Look AHEAD Research Group. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013; 369: 145-54.
Original commentary found in iForumRx.com, written by: By Danielle Hebel, PharmD and Erica Pearce, PharmD, BCPS
This article points out that intensive lifestyle interventions (7% weight loss and increase physical activity 175 min/week) does not impact CV morbidity and mortality or lower CV risk; however, it does have positive outcomes on A1C, HDL, LDL, and mean SBP. In addition, it can lower the risk of urinary incontinence, sleep apnea, and depression, as well as improve quality of life and physical functioning.
Patients in this study were not poorly controlled with their DM as we see in practice. Perhaps in patients who are poorly controlled, intensive lifestyle interventions may lower their CV risk. This commentary questions whether weight loss and exercise should be recommended to all patients with DM. I would say YES; while, weight loss (for patients who are obese) and exercise may not truly show decrease in CV risk, it can still bring other benefits and it does not cause harm; therefore if the pt is able to exercise I would recommend it.