Energy balance
Intensive lifestyle intervention in adults with type 2 diabetes and overweight/obesity produces moderate, sustained weight loss and cardiovascular risk factor control, with significant cardiovascular benefits observed specifically in patients achieving >10% weight loss or >2 MET fitness increase in the first year.
For adults with type 2 diabetes, simply 'trying' lifestyle changes may not be enough to protect your heart. You need to aim for a significant result: losing at least 10% of your body weight or significantly increasing your physical fitness (measured in metabolic equivalents) within the first year. If you achieve this threshold, you are much more likely to see a reduction in cardiovascular outcomes compared to those who maintain their weight or fitness levels.
The intensive lifestyle intervention did not reduce the rate of MACE in Look AHEAD. However, it produced greater weight loss and reductions in A1c versus control, in particular, in the first year. In post hoc analyses, individuals who lost ≥10% of their body weight or had a >2 metabolic equivalent increase in fitness in the first year of the trial experienced reductions in cardiovascular outcomes compared to those with stable weight/weight gain or stable fitness/fitness loss.
Why this rating
Based on a large, well-known randomized controlled trial (Look AHEAD) with long-term follow-up and post-hoc subgroup analysis.
Source
Comprehensive Management of Cardiovascular Risk Factors for Adults With Type 2 Diabetes: A Scientific Statement From the American Heart Association
Joshua J. Joseph et al. · Circulation · 2022
DOI 10.1161/cir.0000000000001040
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