Evidence mapPaperPMID 20876408Full record

Trial reportArchives of internal medicine2010

Long-term effects of a lifestyle intervention on weight and cardiovascular risk factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial.

Look AHEAD Research Group, Rena R Wing

10 registry-linked trialsOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Archives of internal medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 10 registered trials, which are not on this map. Cited by 607 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
607citing papers in PubMed, 13 pooled it
60.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02488057 phase4completedstarted 2016, after this paper: background citation

Improving Beta Cell Function in Mexican American Women With Prediabetes

Ran2016Enrolled360Registered outcomes8Posted comparisons0ConditionsPre-diabetesArmsliraglutide, weight loss
Open the trial in the graph
NCT06000462 phase4active not recruitingstarted 2024, after this paper: background citation

The Effect of Sodium Glucose Co-transporter 2 Inhibitor (dapagliflozin) on Weight Loss in Non-diabetic Adults with Obesity: Triple-blinded, Randomized, Placebo-controlled Trial.

Ran2024Enrolled150Registered outcomes4Posted comparisons0ConditionsDapagliflozin Adverse Reaction, Effect of Drug, Obesity, Weight LossArmsDapagliflozin 10mg Tab, Metformin 1000 mg (ttd), Placebo
Open the trial in the graph
NCT00017953 nacompletednot on this map

Look AHEAD: Action for Health in Diabetes

TypeinterventionalSponsorWake Forest University Health SciencesRan2001 to 2020Enrolled5,145ConditionsDiabetes, Myocardial Infarction, Stroke, Kidney DiseasesArmsLifestyle Intervention, Diabetes Support and Education
NCT01262313 nacompletednot on this map

Healthy Creations: Community Based Lifestyle Intervention Validation

TypeinterventionalSponsorUSDA Grand Forks Human Nutrition Research CenterRan2010 to 2013Enrolled46ConditionsOverweight, ObesityArmsLifestyle Counseling
NCT03196895 nacompletednot on this mapstarted 2017, after this paper: background citation

Treating Type 2 Diabetes by Reducing Postprandial Glucose Elevations: A Paradigm Shift in Lifestyle Modification

TypeinterventionalSponsorUniversity of VirginiaRan2017 to 2020Enrolled192ConditionsDiabetes Mellitus, Type 2ArmsWeight reduction training, PPG training, discrete BG feedback, continuous BG feedback
NCT03207893 nacompletednot on this mapstarted 2018, after this paper: background citation

Benefits of Adding Continuous Glucose Monitoring to Glycemic Load, Exercise, and Monitoring of Blood Glucose (GEM) for Adults With Type 2 Diabetes - Phase 2

TypeinterventionalSponsorUniversity of VirginiaRan2018 to 2020Enrolled24ConditionsDiabetes Mellitus, Type 2ArmsGEM lifestyle modification & continuous glucose monitoring, Routine Care
NCT03397225 nacompletednot on this mapstarted 2013, after this paper: background citation

A Lifestyle Intervention for Type 2 Diabetes Patients in Kuwait and Its Impact on Glycaemic Control

TypeinterventionalSponsorUniversity of ReadingRan2013 to 2016Enrolled40ConditionsDiabetes Mellitus, Noninsulin-Dependent, Diabetes, Type 2ArmsLifestyle intervention
NCT04626323 phase2unknown statusnot on this mapstarted 2021, after this paper: background citation

Open, Randomized, Unicenter Study Comparing Metabolic Surgery With Intensive Medical Therapy to Treat Diabetic Kidney Disease

TypeinterventionalSponsorHospital Alemão Oswaldo CruzRan2021 to 2024Enrolled60ConditionsDiabetes Mellitus, Type 2, Kidney Disease, Chronic, Kidney InjuryArmsRoux-en-Y gastric bypass, Best medical treatment
NCT05755555 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Testing the Effectiveness of Different Messaging Approaches to Increase Doctor Visits to Confirm or Exclude a Diagnosis of Prediabetes or Diabetes Amongst Individuals With Risk Factors for Diabetes: A Randomised, Controlled Trial

TypeinterventionalSponsorWits Health Consortium (Pty) LtdRan2022 to 2023Enrolled5,000ConditionsType 2 Diabetes, Pre-diabetesArmsVisit a doctor
NCT05781269 naactive not recruitingnot on this mapstarted 2022, after this paper: background citation

Metabolic Syndrome and Severe Obesity: Randomized Nutritional Trial to Study Long Term Effect of Very-low-calories Ketogenic Diet (VLCKD) on Weight Control and Cardiovascular Risk Factors

TypeinterventionalSponsorIstituto Auxologico ItalianoRan2022 to 2026Enrolled100ConditionsObesity, Morbid ObesityArmsVLCKD, r-MedDiet
3 · Its place in the literature

Who cites it

607 citing papers in PubMed, 13 syntheses or guidelines pooled it, 1,164 citations in OpenAlex.

  1. Pooled it
  2. Guideline
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  4. Guideline
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  7. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  8. Pooled it
  9. Pooled it
  10. Diet, adiposity, and the gut microbiota from infancy to adolescence: A systematic review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2021
    Pooled it
  11. Pooled it
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  13. Walking for hypertension.The Cochrane database of systematic reviews · 2021
    Pooled it
  14. Trial
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  18. The effect of a community-based health behaviour intervention on health-related quality of life in people with Type 2 diabetes in Nepal: a Cluster Randomized Controlled Trial.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Trial
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  20. Trial

547 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Look AHEAD Research GroupDepartment of Psychiatry, The Miriam Hospital/Brown Medical School, Providence, RI 02860, USA. rwing@lifespan.org
Rena R Wing
Miriam Hospital · US

Funding

ZOPOLRESTAT PHARMACOKINETICS IN DIABETICS WITH VARYING RENAL FUNCTIONM01RR000051 · UNIVERSITY OF COLORADO DENVER · 1985 to 2005
$37.2M
WITHIN SUBJ VARIABILITY IN MEASUREMENTS DRUG METABOL ENZYMES IN HLTY SUBJM01RR000056 · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1985 to 2005
$27.6M
ZD6416 Analgesic--Painful Distal Symmetrical PolyneuropaM01RR001066 · MASSACHUSETTS GENERAL HOSPITAL · 1985 to 2005
$26.1M
HEALTH OUTCOMES OF WEIGHT-LOSS: DATA COORDINATING CENTERU01DK057136 · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 1999 to 2005
$18.5M
ZINC THERAPY FOR SCLERODERMA--PHASE I STUDYM01RR002719 · JOHNS HOPKINS UNIVERSITY · 1986 to 2005
$16.4M
ZOLEDRONATE VS AREDIA IN MULTIPLE MYELOMA/BREAST CANCER W /BONE DISORDERSM01RR001346 · UNIVERSITY OF TEXAS HLTH SCI CTR SAN ANT · 1985 to 2005
$16.1M
Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · 1986 to 2025
$12.6M
Clinical Center for Look AHEAD: Health in DiabetesU01DK057178 · ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS · 1999 to 2005
$9.3M
Clinical Center for Look AHEAD: Health in DiabetesU01DK057151 · UNIVERSITY OF COLORADO DENVER · 1999 to 2005
$8.4M
STUDY OF HEALTH OUTCOMES OF WEIGHT-LOSS (SHOW)U01DK057135 · UNIVERSITY OF PENNSYLVANIA · 1999 to 2005
$8.2M
SHOW PROJECTU01DK057154 · MASSACHUSETTS GENERAL HOSPITAL · 1999 to 2005
$8.1M
STUDY OF HEALTH OUTCOMES OF WEIGHT-LOSS (SHOW) TRIALU01DK056992 · MIRIAM HOSPITAL · 1999 to 2005
$8.1M
Intramural NIH HHSNCRR NIH HHS M01RR000056NCRR NIH HHS M01RR00051NCRR NIH HHS M01RR0021140NCRR NIH HHS M01RR01066NCRR NIH HHS M01RR01346NCRR NIH HHS M01RR02719NCRR NIH HHS UL1 RR 024153NIDDK NIH HHS DK 046204NIDDK NIH HHS DK56990NIDDK NIH HHS DK56992NIDDK NIH HHS DK57002NIDDK NIH HHS DK57008NIDDK NIH HHS DK57078NIDDK NIH HHS DK57131NIDDK NIH HHS DK57135NIDDK NIH HHS DK57136NIDDK NIH HHS DK57149NIDDK NIH HHS DK57151NIDDK NIH HHS DK57154NIDDK NIH HHS DK57171NIDDK NIH HHS DK57177NIDDK NIH HHS DK57178NIDDK NIH HHS DK57182NIDDK NIH HHS DK57219NIDDK NIH HHS P30 DK017047NIDDK NIH HHS P30 DK079637NIDDK NIH HHS P30 DK48520NIDDK NIH HHS U01 DK056992
6 · The paper itself

Abstract

backgroundLifestyle interventions produce short-term improvements in glycemia and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes mellitus, but no long-term data are available. We examined the effects of lifestyle intervention on changes in weight, fitness, and CVD risk factors during a 4-year study.

methodsThe Look AHEAD (Action for Health in Diabetes) trial is a multicenter randomized clinical trial comparing the effects of an intensive lifestyle intervention (ILI) and diabetes support and education (DSE; the control group) on the incidence of major CVD events in 5145 overweight or obese individuals (59.5% female; mean age, 58.7 years) with type 2 diabetes mellitus. More than 93% of participants provided outcomes data at each annual assessment.

resultsAveraged across 4 years, ILI participants had a greater percentage of weight loss than DSE participants (-6.15% vs -0.88%; P < .001) and greater improvements in treadmill fitness (12.74% vs 1.96%; P < .001), hemoglobin A(1c) level (-0.36% vs -0.09%; P < .001), systolic (-5.33 vs -2.97 mm Hg; P < .001) and diastolic (-2.92 vs -2.48 mm Hg; P = .01) blood pressure, and levels of high-density lipoprotein cholesterol (3.67 vs 1.97 mg/dL; P < .001) and triglycerides (-25.56 vs -19.75 mg/dL; P < .001). Reductions in low-density lipoprotein cholesterol levels were greater in DSE than ILI participants (-11.27 vs -12.84 mg/dL; P = .009) owing to greater use of medications to lower lipid levels in the DSE group. At 4 years, ILI participants maintained greater improvements than DSE participants in weight, fitness, hemoglobin A(1c) levels, systolic blood pressure, and high-density lipoprotein cholesterol levels.

conclusionsIntensive lifestyle intervention can produce sustained weight loss and improvements in fitness, glycemic control, and CVD risk factors in individuals with type 2 diabetes. Whether these differences in risk factors translate to reduction in CVD events will ultimately be addressed by the Look AHEAD trial.

trial registrationclinicaltrials.gov Identifier: NCT00017953.

Indexed as

Life StylePatient Education as TopicPhysical FitnessWeight LossAgedBiomarkersBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesCholesterol, HDLCholesterol, LDLDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleHumansBiomarkersBlood GlucoseCholesterol, HDLCholesterol, LDLTriglycerides

Identifiers

PMID20876408
PMCPMC3084497
OpenAlexW1580839177

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.