Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
Harvard Medical School, Boston, Massachusetts, USA.
Obesity (Silver Spring). 2022 Oct;30(10):1938-1950. doi: 10.1002/oby.23508. Epub 2022 Aug 31.
The Reach Ahead for Lifestyle and Health (REAL HEALTH)-Diabetes study assessed the comparative effectiveness of two Look AHEAD (Action for Health in Diabetes)-adapted lifestyle intervention (LI) arms targeting weight loss in type 2 diabetes compared with medical nutrition therapy (MNT) referral. At 1 year, LI had greater weight loss than MNT. This study reports outcomes at 24 (end of LI) and 36 months.
Participants (N = 211) with type 2 diabetes and BMI > 25 kg/m were randomly assigned to in-person LI, telephone conference call LI, or MNT. The primary outcome was percentage weight change. Secondary outcomes included 5% and 10% weight loss, glycated hemoglobin (HbA1c), and patient-reported outcomes.
Participants were 61.7 (SD 10.2) years old; 55% were female; 77% were non-Hispanic White; and had mean (SD) weight of 98 (18.9) kg and mean (SD) HbA1c of 7.7% (1.2%). Mean (SD) weight change at 24 and 36 months was -4.4% (5.9%) and -4.4% (5.4%) in in-person LI, -4.0% (5.8%) and -5.3% (6.4%) in telephone LI, and -3.1% (5.2%) and -5.8% (7.1%) in MNT, with no statistically significant difference in weight or HbA1c at 24 and 36 months. Compared with MNT, LI arms had favorable changes in patient-reported outcomes related to learned dietary skills.
There were no differences in weight outcomes among LI participants compared with referral to MNT at the end of intervention or 1 year after its conclusion.
“展望健康与生活方式”（REAL HEALTH）-糖尿病研究评估了两种针对 2 型糖尿病患者减肥的适应“行动促进糖尿病健康”（Look AHEAD）生活方式干预（LI）手臂与医学营养治疗（MNT）转介的比较效果。在第 1 年，LI 比 MNT 有更大的体重减轻。本研究报告了 24 个月（LI 结束时）和 36 个月的结果。
参与者（N=211）患有 2 型糖尿病和 BMI>25kg/m2，随机分配到面对面 LI、电话会议 LI 或 MNT。主要结果是体重变化的百分比。次要结果包括 5%和 10%的体重减轻、糖化血红蛋白（HbA1c）和患者报告的结果。
参与者的年龄为 61.7（10.2）岁；55%为女性；77%为非西班牙裔白人；平均（SD）体重为 98（18.9）kg，平均（SD）HbA1c 为 7.7%（1.2%）。面对面 LI 在 24 个月和 36 个月的平均（SD）体重变化为-4.4%（5.9%）和-4.4%（5.4%），电话 LI 为-4.0%（5.8%）和-5.3%（6.4%），MNT 为-3.1%（5.2%）和-5.8%（7.1%），24 个月和 36 个月时体重或 HbA1c 无统计学显著差异。与 MNT 相比，LI 组在与学习饮食技能相关的患者报告结果方面有更有利的变化。
在干预结束或干预结束后 1 年，LI 参与者与 MNT 转介相比，体重结果没有差异。
