Energy balance
Intensive lifestyle interventions (diet and exercise) alone do not significantly reduce cardiovascular event risk in overweight/obese adults with type 2 diabetes compared to usual care, whereas weight loss achieved through metabolic surgery significantly reduces complications and mortality.
While healthy eating and exercise are important, they might not be enough to protect your heart if you have type 2 diabetes and are overweight. The Look AHEAD study showed that intensive lifestyle changes didn't lower heart attack or stroke risk compared to standard care. However, losing a significant amount of weight (10% or more) did help. For some, metabolic surgery offers the best chance to reduce complications and live longer. Talk to your doctor about combining lifestyle changes with medications or other treatments.
Intensive lifestyle treatments in the Look AHEAD... randomised controlled trial... did not reduce the risk of cardiovascular events compared to usual care. Weight loss achieved with metabolic surgery reduced the risks of microvascular and macrovascular complications of diabetes and reduced mortality.
Why this rating
Based on a large RCT (Look AHEAD) for lifestyle and multiple studies for surgery.
Source
Advances in the management of type 2 diabetes in adults
Rodolfo J. Galindo et al. · BMJ Medicine · 2023
DOI 10.1136/bmjmed-2022-000372
More from this paper
- For adults with type 2 diabetes and established atherosclerotic cardiovascular disease or high risk, glucagon-like peptide 1 receptor agonists (GLP1RAs) or sodium glucose cotransporter 2 inhibitors (SGLT2is) should be initiated as first-line therapy regardless of baseline HbA1c levels to reduce major adverse cardiovascular events.Strong
- SGLT2 inhibitors are preferred over GLP1RAs for adults with type 2 diabetes and heart failure to reduce major adverse cardiovascular events and worsening heart failure, while GLP1RAs are preferred for chronic kidney disease if SGLT2is are not tolerated.Strong
Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
This is one finding among thousands. Every one is graded and traced to its source, so you can see what the evidence actually supports. Browse the research →