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Intensive lifestyle intervention reduces CVD medication use and cost in Type 2 diabetics

Diabetes Care 2010; 33: 1153–1158

Study results show that intensive lifestyle intervention (ILI) reduces cardiovascular disease (CVD) risk factors more than diabetes support and education (DSE), leading to reduced medication use and lower costs.


Previous results from the Look AHEAD (Action for Health in Diabetes) study, reported by MedWire News, showed that ILI improves quality of life, physical fitness, and weight loss more than DSE in overweight individuals with Type 2 diabetes.

In this study, J Bruce Redmon (University of Minnesota, Minneapolis, USA) and colleagues assessed the impact of ILI versus DSE on use and cost of medications for treatment of CVD in 4358 overweight participants of the Look AHEAD trial aged 45–76 years with complete data at 1 year.

DSE involved general recommendations for healthy eating and increased exercise, attendance at an initial session, and invitations to three additional group sessions over the year. The ILI was more intensive than this, including weekly group treatment and monthly individual sessions with a lifestyle counsellor.

As previously reported, patients in the ILI group had significantly greater improvements in CVD risk factors at 1 year than those in the DSE group.

In this study, the team compared use of medications to treat diabetes, hypertension, and hyperlipidemia in the ILI and DSE groups at baseline and at 1 year as well as the estimated monthly costs of the medications.

Writing in the journal Diabetes Care, Redmon and co-workers report that patients in the ILI group had significantly lower medication use and costs than those in the DSE group.
At baseline, the Look AHEAD participants were taking an average of 3.3 medications at a monthly cost of approximately US $155 (€129).

At 1 year, the average number of CVD-related medications prescribed to ILI patients was 3.1 versus 3.6 for DSE patients. This corresponds to approximate total monthly costs of $143 (€120) and $173 (€145), respectively.

ILI patients who met optimal care goals at 1 year – glycated hemoglobin below 7%, blood pressure below 130/80 mmHg, and low-density lipoprotein cholesterol below 100 mg/dl – were taking an average of 3.2 medications at a mean monthly cost of $154 (€129). This compared with the DSE patients who were taking 3.8 medications on average at a mean monthly cost of $194 (€163).

"Continued intervention and follow-up will determine whether these changes are maintained and reduce cardiovascular risk," conclude Redmon et al.

"If these changes can be sustained for the long term, the public health benefits would be substantial," they add.

Read the abstract


MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2010