An intensified lifestyle intervention programme may be superior to insulin treatment in poorly controlled Type 2 diabetic patients on oral hypoglycaemic agents: results of a feasibility study

• Published in: Diabetic medicine 2005-03, Vol.22 (3), p.316-322
• Main Authors: Aas, A. M., Bergstad, I., Thorsby, P. M., Johannesen, Ø., Solberg, M., Birkeland, K. I.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Anthropometry; Biological and medical sciences; Blood Glucose - analysis; Body Composition; body weight changes; Cholesterol - blood; Cholesterol, HDL - blood; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; diet therapy; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; exercise; Feasibility Studies; Female; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; insulin; Insulin - administration & dosage; Insulin - therapeutic use; Life Style; Male; Medical sciences; Middle Aged; non-insulin-dependent diabetes mellitus; Statistics, Nonparametric; Triglycerides - blood
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2005.01421.x

Aims  The aims of this study were to assess whether, in Type 2 diabetic patients with inadequate glycaemic control on oral hypoglycaemic agents (OHA), a lifestyle intervention programme based on exercise and diet counselling (i) was as effective as insulin treatment in controlling blood glucose, and (ii) could prevent the weight gain usually accompanying the introduction of insulin treatment. Methods  Thirty‐eight Type 2 diabetic subjects treated with OHA, HbA1c 8–10.5% and body mass index (BMI) 26–40 kg/m2, were randomized to the following treatments: (i) lifestyle intervention (L), (ii) lifestyle intervention + insulin treatment (L+I) and (iii) insulin treatment alone (I). Results  There was a reduction in HbA1c of −1.2 (interquartile range 1.0), −1.0 (1.7) and −1.5 (2.5)% in group L, L+I and I, respectively, and all treatment groups achieved beneficial changes in blood lipid variables. There was no significant difference between the groups in the change observed in levels of HbA1c between start and 12 months of treatment (P = 0.74). There was a significant difference in weight changes between groups (P