Intensive diet, exercise remain gold standard for patients with diabetes
By DR. KOMOROFF Universal Uclick on Sep 12, 2013, at 2:21 AM Updated on 9/12/13 at 4:03 AM
Dr. K
Dear Doctor K: I have hypertension. Should I be monitoring my blood pressure at home?
Dear Doctor K: After my last mammogram, the doctor told me I have dense breasts. Does this increase my risk of cancer?
Dear Doctor K: I just heard on the radio that some study says that intensive diet and exercise don't decrease heart disease risk in diabetics. Is this true?
Dear Reader: I assume you're referring to results from the recently publicized Look AHEAD (Action for Health in Diabetes) trial. I've told patients to take these results with several grains of salt.
The Look AHEAD trial explored how changes in diet and exercise affected heart disease risk in this population. Researchers recruited more than 5,000 overweight men and women with Type 2 diabetes. Half were assigned at random to lose weight and maintain their weight loss through intensive diet and exercise. The other group - called a "control group" - met three times a year for group counseling sessions to discuss lifestyle changes to control diabetes.
After almost 10 years, the rates of heart attacks, strokes and heart-related deaths were essentially the same in both groups. That is, until you read the study in detail.
For example, the people in the intensive-change group lost only slightly more weight than the control group: 4 percent versus 2.5 percent. So though the research team called it "intensive diet and exercise," it did not do a lot to achieve the goal of weight loss.
A second important difference is that the latter group was taking more heart-healthy medicines. So any real benefits from the slightly better weight loss in the intensive-change group might have been canceled out by this difference in medicines.
Lifestyle changes did have some health benefits in this study. People in the intensive-change group improved their blood sugar with fewer drugs, and they lowered their risk for other diabetes complications such as chronic kidney disease and vision problems.
Write Dr. K at
www.AskDoctorK.com or c/o Universal Uclick, 1130 Walnut, Kansas City, MO 64106
Dr. K
Dear Doctor K: I have hypertension. Should I be monitoring my blood pressure at home?
Dear Doctor K: After my last mammogram, the doctor told me I have dense breasts. Does this increase my risk of cancer?
