Tim Reynolds, MD
Is an intensive lifestyle intervention (ILI) better than diabetes support and education (DSE) for weight loss and obstructive sleep apnea (OSA) in patients with obesity and type 2 diabetes?
Randomized controlled trial (Sleep Action for Health in Diabetes [Sleep AHEAD] study; a substudy of the Look AHEAD study). ClinicalTrials.gov NCT00194259.
Blinded (sleep technicians and polysomnogram [PSG] assessors).*
4 university sites (Philadelphia, Pittsburgh, New York, and Providence) in the USA.
264 patients 45 to 75 years of age (mean age 61 y, 59% women) who had OSA, body mass index ≥ 25 (≥ 27 if using insulin), physician-confirmed type 2 diabetes, hemoglobin A1c level < 11%, and blood pressure reading < 160/100 mm Hg. Exclusion criteria included past surgery and current medical treatment for OSA.
125 patients were allocated to ILI, a diabetes-specific group, behavioral, weight-loss program that included portion-controlled diets and physical activity, and 139 were allocated to DSE with 3 group sessions over 1 year focusing on diet, physical activity, and social support.
Included weight loss and PSG-assessed apnea–hypopnea index (AHI, sum of episodes of apnea and hypopnea per hour).
The main results are in the Table.
In obese patients with type 2 diabetes, an intensive lifestyle intervention improved weight loss and obstructive sleep apnea more than diabetes support and education.
Intensive lifestyle intervention (ILI) vs diabetes support and education (DSE) in obese patients with type 2 diabetes†
†AHI = apnea-hypopnea index (sum of episodes of apnea and hypopnea per hour); OSA = obstructive sleep apnea; other abbreviations defined in Glossary. RBI, RRR, NNT, and CI calculated from data in article.
‡Adjusted by research site.
Reynolds T. A lifestyle intervention improved obstructive sleep apnea more than support and education in obese patients with diabetes. Ann Intern Med. ;152:JC1–5. doi: 10.7326/0003-4819-152-2-201001190-02005
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Published: Ann Intern Med. 2010;152(2):JC1-5.
Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism, Obesity.
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