Lifestyle changes not enough to tame heart problems in type 2 diabetics

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A healthy lifestyle focused on a balanced diet and exercise may help those with type 2 diabetes keep their cholesterol and blood glucose at bay, but ultimately, it won t protect them from heart problems, according to a new study. The trial was halted in September after data showed that lifestyle intervention in patients with type 2 diabetes showed no significant benefit to cardiovascular health.

Researchers reported their findings to the American Diabetes Association and the New England Journal of Medicine. They explained the disappointing findings by noting that the participants in the control group were already taking more medications, more specifically statins, which could have lowered their risk of heart problems, in addition to receiving good health education. However, the trial was valuable in that it showed patients with diabetes can lose weight and maintain that weight loss, researchers noted. Previous studies have shown that weight loss can improve cardiovascular benefits in those patients, but long-term effects have not been thoroughly studied.

More than 5,000 overweight or obese participants with type 2 diabetes were randomized into two groups: one engaged in intensive lifestyle changes focusing on weight loss, while the control group only received education about their disease. Although there was a slight difference in weight loss between the groups with a significant reduction in glycated hemoglobin (a measure of blood sugar control) in the intervention group, those differences diminished over time, researchers said.

Over the course of the almost-ten-year follow-up, the intervention group had no significant added benefit, as compared to the education-only control group, in a composite of death from cardiovascular causes, nonfatal MI, nonfatal stroke, and hospitalization for angina.

ACSH s Dr. Gilbert Ross s perspective was on the optimistic side: While these results don t support a specific benefit, it is simply common sense to see that improved weight loss and better glycemic control must have better outcomes, if nothing else based on lower blood pressure accompanying weight loss. If these data don t show that, the study was flawed in some way, perhaps by being too small or not long enough, or the improvement did not reach the magical statistical significance.