Adherence
An intensive lifestyle intervention (diet and exercise) reduces major cardiovascular events in middle-aged women with poorly controlled diabetes and poor subjective health, but shows no benefit for middle-aged/older men with well-controlled diabetes and excellent health.
If you have type 2 diabetes and are overweight, standard lifestyle advice may not reduce your heart disease risk equally. If you are a middle-aged woman with poorly controlled diabetes and feel your general health is poor, an intensive lifestyle program focusing on weight loss and exercise is likely to help prevent heart events. However, if you are a man with well-controlled diabetes and feel you are in excellent health, this specific intensive intervention may not provide cardiovascular benefits. Consult your doctor to see if your specific profile matches the subgroup that benefits.
The covariate profiles for which there is sufficient evidence of treatment benefit are, coarsely, middle-aged women, in poor subjective general health and with moderately to poorly controlled diabetes... Conversely, the covariate profiles that are likely to be associated with no benefit are middle aged and older men in excellent subjective general health, with well-controlled diabetes.
Why this rating
Based on a large multicenter RCT (Look AHEAD) with rigorous Bayesian subgroup analysis, though the specific subgroups are small (0.5% and <2% of participants).
Source
Using the Bayesian credible subgroups method to identify populations benefiting from treatment: An application to the Look AHEAD trial
Anna Coonan et al. · PLoS ONE · 2020
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