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Solid Evidence of Sustained Benefit
For patients with type 2 diabetes, these exciting findings provide solid evidence of the sustained benefit of simple interventions on numerous important cardiovascular risk factors. The results are particularly encouraging because, unlike drug therapy for the disorder, lifestyle interventions carry little risk of inducing hypoglycemia, said Dr. Prakash C. Deedwania.
However, it is unlikely that the frequent and regular instruction, visits with registered dietitians and exercise specialists, special diets given free of charge, and monetary incentives used in this intervention can be translated on a broad scale to clinical practice. And the recidivism that occurred over time toward baseline levels raises questions about the long-term sustainability of such an intensive intervention in everyday clinical practice.
Overall, however, the LookAHEAD findings show that “simple, established approaches based on conventional wisdom work well, and there is no need to rush to newer or novel approaches unless convincing evidence supports such a move,” he said.
DR. DEEDWANIA is chief of cardiology at Veterans Affairs Central California Health Care System, Fresno. He reported no relevant financial disclosures. These comments are taken from his editorial accompanying the LookAHEAD report (Arch. Intern. Med. 2010;170:1575-7).
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