Posted by Medivizor on Jun 12, 2015 in Diabetes mellitus |
In a nutshell
This study investigated the effect of a reduced calorie diet and exercise on the occurrence and/or severity of depression in overweight and obese type 2 diabetes patients.
Some background
Patients with diabetes are at a high risk of depression and tend to have a poor quality of life, particularly in their perception of their general health and physical functioning. Obesity in diabetes is associated with depression, reduced quality of life and increased risk of complications.
Intensive lifestyle intervention (ILI) is a weight loss treatment in which changes are made to diet and exercise. While this type of intervention has been associated with significant weight reduction in short term studies, it remains to be seen if the benefits exist in the long-term. Also, there are some concerns that there are some adverse psychological effects associated with these intensive interventions, as witnessed in some early weight loss programs.
Methods & findings
5,145 overweight/obese diabetes patients from the US were followed for approximately 10 years. Patients were split into two groups; patients in the ILI group (2,570) aimed for 7% weight reduction by achieving a goal of 1,200 – 1,800 k/cals per day and >175 minutes of moderate intensity exercise (i.e. brisk walking) per week. These participants were seen in a combination of individual and group sessions weekly for the first 6 months and 3 times per month for the following 6 months. Sessions addressed behavioural strategies. Following the first year, patients were offered monthly in-person sessions. In the diabetes support and edication (DSE) group (2,575) patients attended 3 group sessions per year for the first 4 years to address general issues of diet, exercise and social support.
At the end of year 1, patients in the ILI group lost an average of 8.6% of their initial weight, while patients in the DSE group lost 0.7% of their initial weight. By the end of the study, patients in the ILI group had lost 6% of their initial weight and patients in the DSE group had lost 3.5% of their initial weight.
The study found that ILI patients who did not have depression at the beginning of the study had a 15% reduced chance of developing mild or greater depression compared to DSE patients. Results also showed that DSE patients’ physical quality of life scores decreased more during the study than the ILI patients’ scores did.
The bottom line
This study concluded that ILI is associated with a decreased risk of getting mild or greater depression in people with type 2 diabetes.
The fine print
The DSE group had less support sessions than the ILI group. Furthermore, the ILI group had greater associations with depression than the DSE group at the beginning of the study. The reduced occurrence and level of depression observed in the ILI group could have been due to one or a combination of these factors.
What’s next?
Consult with your doctor if you feel you would be interested in using an intensive lifestyle intervention for your diabetes.
Published By :
Diabetes Care
Original Title :
Impact of Intensive Lifestyle Intervention on Depression and Health-Related Quality of Life in Type 2 Diabetes: The Look AHEAD Trial.
