scholarly journals Effect of Intensive Lifestyle Intervention on Sexual Dysfunction in Women With Type 2 Diabetes: Results from an ancillary Look AHEAD study

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 2937-2944 ◽  
Author(s):  
R. R. Wing ◽  
D. S. Bond ◽  
I. N. Gendrano ◽  
T. Wadden ◽  
J. Bahnson ◽  
...  
2021 ◽  
Author(s):  
Michael P. Bancks ◽  
Haiying Chen ◽  
Ashok Balasubramanyam ◽  
Alain G. Bertoni ◽  
Mark A. Espeland ◽  
...  

<b>Objective:</b> We re-evaluated the Action for Health in Diabetes (Look AHEAD) intervention, incorporating diabetes subgroups, to identify whether intensive lifestyle intervention (ILI) is associated with differential risk for cardiovascular disease (CVD) by diabetes subgroup. <p><b>Research Design and Methods: </b>Look AHEAD randomized 5145 participants, aged 45-76 years, with type 2 diabetes (T2D) and overweight or obesity, to 10 years of ILI or a control condition of diabetes support and education. ILI focused on weight loss through decreased caloric intake and increased physical activity. To characterize diabetes subgroups, we applied k-means clustering to data for age of diabetes diagnosis, body mass index, waist circumference, and glycated hemoglobin. We examined whether relative intervention effects on the trial’s prespecified CVD outcomes varied among diabetes subgroups.</p> <p><b>Results:</b> We characterized four subgroups related to older age at diabetes onset (42% of sample), poor glycemic control (14%), severe obesity (24%), and younger age at onset (20%). We observed interactions (all p<0.05) between intervention and diabetes subgroup for three separate composite cardiovascular outcomes. Randomization to ILI was associated with increased risk for each cardiovascular outcome only among the poor glucose control subgroup (hazard ratios, HR >1.32). Among the three other diabetes subgroups, ILI was not associated with increased risk for CVD.</p> <p><b>Conclusion:</b> Among overweight and obese adults with T2D, a lifestyle intervention was associated with differential risk for CVD that was dependent on diabetes subgroup. Diabetes subgroups may be important to identify the patients who would achieve benefit and avoid harm from an intensive lifestyle intervention.</p>


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daisy Duan ◽  
Scott J Pilla ◽  
Jeanne M Clark ◽  
Nisa M Maruthur

Background: Breakfast skipping is linked to obesity and related cardiometabolic outcomes in observational studies, but the association between breakfast eating and weight loss is not well-established. We examined if weight loss outcomes in Look AHEAD were related to breakfast consumption frequency (BCF). Methods: We included a subset of participants (n=3862) from the public access dataset of Look AHEAD, an RCT that compared intensive lifestyle intervention (ILI) to diabetes support and education (DSE) control in adults with overweight/obesity and type 2 diabetes. A self-reported questionnaire collected BCF over a 7-day week annually. This value (0-7) was averaged across 4 years of the intervention to calculate an average BCF. We used robust multivariable linear regression analysis to estimate the association between % weight change and 4-year average BCF controlling for baseline sociodemographics, BMI, and diabetes-related variables. In separate models, we adjusted for self-reported caloric intake (n=880) and self-reported physical activity level (n=735) among those with data. Results: 4-year average BCF was similar in DSE (n=1914) and ILI (n=1948) arms, with a median of 7 days (IQR 6-7) for both arms (p=0.11). Each 1 day increase in average BCF was associated with an additional 0.43% weight loss in the ILI arm (p=0.002) but not in the DSE arm (β-coefficient 0.04% weight loss; p=0.73; p-interaction for arm x BCF=0.01). This association in the ILI arm remained significant after adjustment for daily caloric intake (p=0.04) but not after adjustment for physical activity (p=0.16). Conclusions: Breakfast consumption was associated with greater weight loss in subjects who received ILI, which was attenuated after adjustment for caloric intake and physical activity. To optimize weight loss interventions, the relationship between breakfast consumption and other weight loss behaviors should be further explored.


Obesity ◽  
2016 ◽  
Vol 24 (4) ◽  
pp. 856-864 ◽  
Author(s):  
Ping Zhang ◽  
Don Hire ◽  
Mark A. Espeland ◽  
William C. Knowler ◽  
Sheikilya Thomas ◽  
...  

2014 ◽  
Vol 192 (1) ◽  
pp. 144-149 ◽  
Author(s):  
Benjamin N. Breyer ◽  
Suzanne Phelan ◽  
Patricia E. Hogan ◽  
Raymond C. Rosen ◽  
Abbas E. Kitabchi ◽  
...  

Diabetes Care ◽  
2014 ◽  
Vol 37 (8) ◽  
pp. e169-e170 ◽  
Author(s):  
Geoffrey C. Williams ◽  
Christopher P. Niemiec ◽  
Ari J. Elliot ◽  
Jennifer G. LaGuardia ◽  
Amy A. Gorin ◽  
...  

2021 ◽  
Author(s):  
Michael P. Bancks ◽  
Haiying Chen ◽  
Ashok Balasubramanyam ◽  
Alain G. Bertoni ◽  
Mark A. Espeland ◽  
...  

<b>Objective:</b> We re-evaluated the Action for Health in Diabetes (Look AHEAD) intervention, incorporating diabetes subgroups, to identify whether intensive lifestyle intervention (ILI) is associated with differential risk for cardiovascular disease (CVD) by diabetes subgroup. <p><b>Research Design and Methods: </b>Look AHEAD randomized 5145 participants, aged 45-76 years, with type 2 diabetes (T2D) and overweight or obesity, to 10 years of ILI or a control condition of diabetes support and education. ILI focused on weight loss through decreased caloric intake and increased physical activity. To characterize diabetes subgroups, we applied k-means clustering to data for age of diabetes diagnosis, body mass index, waist circumference, and glycated hemoglobin. We examined whether relative intervention effects on the trial’s prespecified CVD outcomes varied among diabetes subgroups.</p> <p><b>Results:</b> We characterized four subgroups related to older age at diabetes onset (42% of sample), poor glycemic control (14%), severe obesity (24%), and younger age at onset (20%). We observed interactions (all p<0.05) between intervention and diabetes subgroup for three separate composite cardiovascular outcomes. Randomization to ILI was associated with increased risk for each cardiovascular outcome only among the poor glucose control subgroup (hazard ratios, HR >1.32). Among the three other diabetes subgroups, ILI was not associated with increased risk for CVD.</p> <p><b>Conclusion:</b> Among overweight and obese adults with T2D, a lifestyle intervention was associated with differential risk for CVD that was dependent on diabetes subgroup. Diabetes subgroups may be important to identify the patients who would achieve benefit and avoid harm from an intensive lifestyle intervention.</p>


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