Weight loss and increased fitness could reduce CVD risk in type 2 diabetes

Overweight and obese adults with type 2 diabetes could experience a 20 per cent reduced risk of cardiovascular disease if they lose 10 per cent of their body weight, a study reports.
Researchers at the LOOK AHEAD research group made this conclusion following an analysis of The Action for Health in Diabetes (LOOK AHEAD) trial, which began in 2001.
The trial involved 5,145 adults with type 2 diabetes who were overweight or obese, all of whom were aged between 45 and 76 years.
The participants were then randomised to receive either an intensive lifestyle intervention or diabetes support and education. The latter intervention served as the control group.
In the original trial, no significant benefits were observed regarding morbidity and mortality from cardiovascular disease among the intervention group.
But in this new post-hoc analysis, scientists examined links between degree of weight loss and changes in physical fitness within the first year of the study compared to incidences of cardiovascular disease.
In both intervention and control groups, the participants who lost 10 per cent of their body weight during this time had a 21 per cent reduced risk of cardiovascular disease. Additionally, participants had a 24 per cent lower risk of total mortality.
These results remained significant even after adjustment for sex, age, diabetes duration and smoking status, among other variables.
Increased fitness was associated with reduced cardiovascular disease in both groups, and each standard deviation of weight loss was associated with a 15 per cent reduced risk.
Edward W. Gregg, PhD, and colleagues wrote: “There are subtle but important differences in interpretation between the two analyses presented here, which complement the original null intention-to-treat findings.
“These findings, combined with evidence for reduced incidence of diabetes, hypertensio, disability and other benefits, suggest that approaches to identify individuals most likely to benefit from lifestyle interventions should be refined, and strategies should be developed to improve the magnitude of sustained weight loss with lifestyle interventions.”
The study was published in The Lancet Diabetes and Endocrinology.