Mixed
Intensive lifestyle intervention (ILI) for weight loss in type 2 diabetes patients with poor glucose control (HbA1c >9%) is associated with an increased risk of cardiovascular disease events, whereas it reduces risk in patients with older onset, severe obesity, or younger onset.
If you have type 2 diabetes and your blood sugar control is consistently poor (high HbA1c), an intensive weight loss program involving strict diet and heavy exercise might actually increase your risk of heart problems. You should discuss your specific glucose control levels with your doctor before starting an intensive lifestyle intervention, as standard advice may not apply to your specific metabolic subgroup.
Among participants in the poor-glucose-control subgroup, random assignment to the ILI was associated with 85% higher HRs for the primary outcome (HR 1.85; 95% CI 1.32, 2.61)... Among the three other diabetes subgroups, ILI was not associated with increased risk for CVD.
Why this rating
Based on a large, randomized controlled trial (Look AHEAD) with long follow-up, though the subgroup analysis is post hoc.
Source
Type 2 Diabetes Subgroups, Risk for Complications, and Differential Effects Due to an Intensive Lifestyle Intervention
Michael P. Bancks et al. · Diabetes Care · 2021
DOI 10.2337/dc20-2372
Related findings · Mixed
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