Abstract
Background
Intensive lifestyle interventions (ILI) for type 2 diabetes (T2D) improve health outcomes,
but participants from different races/ethnicities or socioeconomic status may not
benefit equally.
Methods
Within the Look AHEAD trial, we examined achievement of the 7% weight loss goal, as
well as secondary weight, cardiovascular, and mortality outcomes, by race/ethnicity
and educational attainment (EA).
Results
Among 4,640 participants (31 % Black or Hispanic, 13 % with less than a high school
degree), Black and Hispanic participants were less likely than White participants
to achieve 7 % weight loss in both the ILI (45.8 % v. 60.7 %, p < 0.001 and 53.0 %
v. 60.7 %, p = 0.01, respectively) and diabetes support and education (DSE) arms.
Contrastingly, participants with less than a high school degree were more likely in
the ILI but less likely in the DSE arm to achieve this goal, with a significant arm
by EA interaction. Hispanic participants and those with lowest EA also experienced
decreased mortality in the ILI versus the DSE arm.
Conclusions
All Look AHEAD participant subgroups achieved greater weight loss from ILI; however,
Black and Hispanic participants lost less weight than White participants in both arms,
while those with lowest EA benefited disproportionately from the ILI compared to participants
with higher EA.
Keywords
Abbreviations:
T2D (type 2 diabetes), ILII (intensive lifestyle intervention), DSE (diabetes support and education), Look AHEAD (Action for Health in Diabetes), HS (high school), SES (socioeconomic status)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 26, 2022
Accepted:
September 21,
2022
Received in revised form:
September 2,
2022
Received:
February 18,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
