Mixed
Long-term follow-up (median 14 years) of an intensive lifestyle intervention (ILI) targeting weight loss and physical activity in adults with type 2 diabetes and obesity does not significantly reduce the prevalence of frailty compared to diabetes support and education (DSE).
For older adults with diabetes, intensive lifestyle interventions (diet and exercise) provide short-to-medium term benefits in physical function, but these benefits may not persist enough to prevent the clinical syndrome of frailty 14 years later. Sustainable, long-term maintenance of lifestyle changes is critical, as the benefits of intensive programs tend to fade after structured support ends.
Prior randomization to ILI compared with DSE was not associated with a lower prevalence of frailty after a median follow-up of 14.0 years in adults with diabetes and overweight or obesity.
Why this rating
Large randomized controlled trial (Look AHEAD) with long-term follow-up and rigorous statistical adjustments, though the primary outcome was null.
Source
The Association of Prior Intensive Lifestyle Intervention and Diabetes Support and Education With Frailty Prevalence at Long-Term Follow-Up in the Action for Health in Diabetes Extension Study
Sara Espinoza et al. · The Journals of Gerontology Series A · 2021
DOI 10.1093/gerona/glab312
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