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 are a middle-aged woman with type 2 diabetes that is not well-controlled and you feel your general health is poor, an intensive lifestyle program focusing on weight loss and exercise is likely to reduce your risk of heart events. However, if you are a man with well-controlled diabetes and feel healthy, this specific intensive approach may not offer cardiovascular protection. Consult your doctor to see if your specific profile matches the 'benefiting' subgroup.
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, long-term RCT (Look AHEAD) using a rigorous Bayesian statistical method to identify subgroups, though the overall trial was negative.
Source
Using the Bayesian credible subgroups method to identify populations benefiting from treatment: An application to the Look AHEAD trial
Anna Coonan et al. · medRxiv · 2019
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