Intensive lifestyle intervention is particularly advantageous in poorly controlled type 2 diabetes

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2017-08, Vol.27 (8), p.688-694
• Main Authors: Sbroma Tomaro, E, Pippi, R, Reginato, E, Aiello, C, Buratta, L, Mazzeschi, C, Perrone, C, Ranucci, C, Tirimagni, A, Russo, A, Fatone, C, Fanelli, C, De Feo, P
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers - blood; Blood Glucose - drug effects; Blood Glucose - metabolism; Cardiovascular; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - physiopathology; Diabetes Mellitus, Type 2 - therapy; Diet, Healthy; Exercise; Exercise Therapy; Female; Glycated Hemoglobin A - metabolism; Glycometabolic control; Glycosylated haemoglobin; Humans; Hypoglycemic Agents - therapeutic use; Lifestyle intervention; Lipids - blood; Male; Middle Aged; Muscle Strength; Nutritional Status; Risk Reduction Behavior; Time Factors; Treatment Outcome; Type 2 diabetes; Weight Loss
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2017.06.009

Abstract Background and aims It is unknown whether lifestyle change is effective in people with type 2 diabetes with inadequate glucose control. The aim of this study was to asses, in a group of people with type 2 diabetes, the impact of baseline values of glycosylated haemoglobin (HbA1c) on the effects of an intensive lifestyle intervention on metabolic, clinical and strength parameters. Methods and results 222 people with type 2 diabetes with mean±standard deviation baseline HBA1c of 7.50%±1.27 (range 5.1-12.7%), were enrolled in a 3-month structured multidisciplinary lifestyle intervention. Anthropometric, biochemical, clinical and fitness measurements were collected at baseline, at the end of the lifestyle intervention program and at two-year follow-up visit. Significant improvements in glycometabolic control (HbA1c: p ≤0.0001); anthropometric parameters (BMI p ≤0.0001; waist circumference: p ≤0.0001); and systemic blood pressure (p ≤0.0001) were observed both at the end of the three month intensive lifestyle program and at the two-year follow up visit. In addition, defined daily doses of hypoglycaemic treatment significantly decreased (p=0.001). Fitness measures exhibited significant increments in the whole sample at the end of the intensive intervention program (p ≤0.0001). When patients were divided in tertiles considering the baseline value of HbA1c, the most marked improvements in HbA1c, blood glucose and triglycerides were observed in the group with inadequate glucose control (Hba1c ≥7.71%), both at the three-month and two-year follow-ups. Conclusion These results demonstrate that an intensive lifestyle intervention should be recommended for people with type 2 diabetes, particularly those with the most inadequate glycaemic control. Registration Number CURIAMO trial was registered in the Australian New Zealand Clinical Trials Registry, ACTRN12611000255987)