scholarly journals Prevalence and Predictors of Abnormal Cardiovascular Responses to Exercise Testing Among Individuals With Type 2 Diabetes: The Look AHEAD (Action for Health in Diabetes) study

Diabetes Care ◽  
2010 ◽  
Vol 33 (4) ◽  
pp. 901-907 ◽  
Author(s):  
J. M. Curtis ◽  
E. S. Horton ◽  
J. Bahnson ◽  
E. W. Gregg ◽  
J. M. Jakicic ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Exercise Testing ◽  
Cardiovascular Responses ◽  
Look Ahead ◽  
The Look

170-OR: Association of Timing of Physical Activity Bouts with Cardiorespiratory Fitness in Adults with Type 2 Diabetes in the Look AHEAD Study

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 170-OR
Author(s):  
JINGYI QIAN ◽  
MICHAEL P. WALKUP ◽  
SHYH-HUEI CHEN ◽  
PETER H. BRUBAKER ◽  
DALE BOND ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cardiorespiratory Fitness ◽  
Look Ahead ◽  
The Look

scholarly journals Association Between Change in Accelerometer-Measured and Self-Reported Physical Activity and Cardiovascular Disease in the Look AHEAD Trial

2022 ◽  
Author(s):  
John M. Jakicic ◽  
Robert I. Berkowitz ◽  
Paula Bolin ◽  
George A. Bray ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Proportional Hazards ◽  
Secondary Analysis ◽  
Cox Proportional Hazards ◽  
Self Report ◽  
Look Ahead ◽  
The Look

OBJECTIVE: To conduct <i>post-hoc</i> secondary analysis examining the association between change in physical activity (PA), measured with self-report and accelerometry, from baseline to 1 and 4 years and cardiovascular disease (CVD) outcomes in the Look AHEAD Trial. <p>RESEARCH DESIGN AND METHODS: Participants were adults with overweight/obesity and type 2 diabetes with PA data at baseline and year 1 or 4 (n = 1,978). Participants were randomized to diabetes support and education or intensive lifestyle intervention. Measures included accelerometry-measured moderate-to-vigorous PA (MVPA), self-reported PA, and composite (morbidity and mortality) CVD outcomes.</p> <p>RESULTS: In pooled analyses of all participants, using Cox proportional hazards models, each 100 MET-min/wk increase in accelerometry-measured MVPA from baseline to 4 years was associated with decreased risk of the subsequent primary composite outcome of CVD. Results were consistent for changes in total MVPA [HR=0.97 (95% CI: 0.95, 0.99)] and MVPA accumulated in <u>></u>10-minute bouts [HR=0.95 (95% CI: 0.91, 0.98)], with a similar pattern for secondary CVD outcomes. Change in accelerometry-measured MVPA at 1 year and self-reported change in PA at 1 and 4 years were not associated with CVD outcomes.</p> <p>CONCLUSIONS: Increased accelerometry-measured MVPA from baseline to year 4 is associated with decreased risk of CVD outcomes. This suggests the need for long-term engagement in MVPA to reduce the risk of CVD in adults with overweight/obesity and type 2 diabetes.</p>

scholarly journals Effectiveness of Lifestyle Interventions for Individuals With Severe Obesity and Type 2 Diabetes: Results from the Look AHEAD trial

Diabetes Care ◽  
2011 ◽  
Vol 34 (10) ◽  
pp. 2152-2157 ◽  
Author(s):  
J. L. Unick ◽  
D. Beavers ◽  
J. M. Jakicic ◽  
A. E. Kitabchi ◽  
W. C. Knowler ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Severe Obesity ◽  
Lifestyle Interventions ◽  
Look Ahead ◽  
The Look

scholarly journals Effect of improved fitness beyond weight loss on cardiovascular risk factors in individuals with type 2 diabetes in the Look AHEAD study

2012 ◽  
Vol 21 (5) ◽  
pp. 608-617 ◽  
Author(s):  
Bethany Barone Gibbs ◽  
Frederick L Brancati ◽  
Haiying Chen ◽  
Mace Coday ◽  
John M Jakicic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Look Ahead ◽  
The Look

P4990Heterogeneity 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

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T I De Vries ◽  
J A N Dorresteijn ◽  
Y Van Der Graaf ◽  
F L J Visseren ◽  
J Westerink
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Effect ◽  
Patient Characteristics ◽  
Treatment Benefit ◽  
Significant Treatment ◽  
Intensive Lifestyle Intervention ◽  
Look Ahead ◽  
The Look

Abstract Background The Action for Health in Diabetes trial (Look AHEAD) randomized overweight and obese patients with type 2 diabetes to either an intensive lifestyle intervention (ILI) or diabetes support and education (DSE). The trial was stopped early for futility after a median follow-up of 9.6 years due to a lack of effect on cardiovascular disease outcomes, despite beneficial effects on metabolic control and cardiovascular risk factors. Subgroup analyses identified no subgroups based on baseline characteristics with a significant treatment effect. However, traditional simple subgroup analyses have several disadvantages compared to a multivariable risk-based approach to identify heterogeneity of treatment effects (HTE). Purpose To explore the possible presence of HTE of an ILI on the occurrence of major cardiovascular events (4-point MACE: nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, and death from cardiovascular causes) in overweight or obese patients with type 2 diabetes mellitus, and to identify patient characteristics associated with treatment. Methods In 4,901 patients from Look AHEAD, a ridge penalized Cox regression model to predict treatment effect of ILI versus DSE on the risk of MACE was derived including all possible treatment-by-covariate interaction terms. Next, the ability of the model to predict HTE was confirmed by calculating hazard ratios (HR) and absolute risk change in quartiles of predicted treatment effect, thereby leaving randomization intact. Finally, baseline patient characteristics were compared between quartiles of predicted treatment effect. Results During a median follow-up of 9.4 years, 799 events occurred (Fig. 1A). The derived risk model showed good internal calibration, with a C-statistic for discrimination of 0.73 (95% confidence interval [95% CI] 0.71–0.73). The median estimated absolute treatment effect on 10 year risk for MACE with ILI was −1.3% and varied substantially, ranging from −39% to +43% (Fig. 1B). In quartile 1, the quartile with the highest benefit, there was a significant treatment benefit of ILI versus DSE (HR 0.64; 95% CI 0.49–0.83), while there was no effect from treatment in quartiles 2 and 3 (HR 0.81, 95% CI 0.58–1.14, and 1.13, 95% CI 0.80–1.60, respectively), and a detrimental effect in quartile 4 (HR 1.37, 95% CI 1.09–1.73) (Fig. 1C). Patient characteristics most notably associated with higher benefit of ILI were higher age, male sex, higher socio-economic status, no history of cardiovascular disease, no use of insulin, higher blood pressure, lower HbA1c, and the presence of micro-albuminuria but absence of macro-albuminuria. Figure 1 Conclusion This post-hoc analysis of the Look AHEAD trial shows evidence of considerable HTE of an intensive lifestyle intervention aimed at weight loss for reducing MACE. Future research into ILI for MACE risk reduction should be specifically aimed at subgroups of patients with a high likelihood of treatment benefit. Acknowledgement/Funding None

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