Look AHEAD: Lifestyle Intervention Cost-Effective in Overweight Patients with Type 2 Diabetes

But it fails to reduce the number of CV events
August 2013, Vol 6 ADA 2013 Highlights
Wayne Kuznar

Chicago, IL—An intensive lifestyle intervention designed for weight loss had no significant effect on the risk of cardiovascular (CV) events after a dec­ade compared with diabetes support and education, but it did lead to reduced use of antidiabetes and cardiac medications, fewer hospitalizations, and lower cost, reported researchers at the 2013 American Diabetes Association annual meeting.

The study, called Look AHEAD, was conducted at 16 centers in the United States. It enrolled 5145 overweight or obese patients with type 2 diabetes who were randomly assigned to intensive lifestyle intervention that was intended to promote weight loss or to diabetes support and education.

Reduced Healthcare Utilization, Costs

The rates of hospitalizations were 11.9% lower in the intensive lifestyle intervention group compared with the diabetes education group (0.193 vs 0.17 hospitalizations annually, respectively; P = .003), which translated into an annual reduction in cost of $294 (P = .03; Table), said Henry A. Glick, PhD, Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.


Table

The proportion of patients receiving home care was reduced by 16.2%—from 7.4% in the education group to 6.2% in the lifestyle intervention group (P = .003).

The number of medications per participant was reduced by 6.3% with the lifestyle intervention, from 4.92 to approximately 4.61 annually (P <.001), leading to a 10-year cost offset of $2455 annually and an annual savings of $278. The present discounted value of 10 years of costs for diabetes education was $77,124 versus $71,746 for lifestyle intervention—a savings of $5378 (P <.001).

The largest relative reductions in medication use in the lifestyle intervention group were for diabetes drugs (13.3%; P <.001), lipid-lowering drugs (6.1%; P = .003), and antihypertensive drugs (4.9%; P = .02). The average overall annual costs were $8807 for the education group and $8205 for the lifestyle intervention group (P = .001).

The data do not include the cost of interventions, making it unclear whether intensive lifestyle intervention reduced the total costs, said Dr Glick.

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Last modified: October 7, 2013
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