Energy balance
Intensive lifestyle intervention (caloric restriction and increased physical activity) aiming for ≥7% weight loss in overweight/obese adults with type 2 diabetes does not significantly reduce the rate of major cardiovascular events or mortality compared to diabetes support and education, despite significant improvements in intermediate risk factors.
If you have type 2 diabetes, intensive lifestyle changes to lose 7% of your body weight will significantly improve your blood sugar, blood pressure, and fitness, but it may not be enough on its own to prevent heart attacks or strokes. You should still do it for other health benefits like kidney protection and mobility, but do not assume weight loss replaces the need for cardiovascular medications or monitoring.
ILI was unable to reduce cardiovascular events and mortality... After 11 years, the results showed no significant difference in the primary outcome between the two groups despite substantial reductions in bodyweight and improvements in many CVD risk factors... Indeed, the trial concluded in 2012 after a median follow up of 9.6 years, when interim analyses suggested that it was very unlikely that further follow up would yield a different result.
Why this rating
Based on the Look AHEAD trial, described as the 'largest landmark study' and 'longest intervention study of its type ever undertaken for diabetes' with >5,000 participants and 11-year follow-up.
Source
Look Action for Health in Diabetes trial: What we have learned in terms of real world practice and clinical trials
Ching‐Fai Kwok et al. · Journal of Diabetes Investigation · 2014
DOI 10.1111/jdi.12231
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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
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