Evidenced-based, Personalized, and Lifestyle Approaches to Diabetes

The following highlights some of the sessions at the 2012 Global Diabetes Summit, hosted by Ohio State’s Diabetes Research Center at Wexner Medical Center.

Look AHEAD — what were the takeaways?

We have had much pharmaceutical successes in working towards a cure for diabetes — every year or two we have one or two new drugs for treatment. But researchers hypothesized intensive lifestyle interventions might be the key for the management of diabetes specifically for preventing cardiovascular disease.

Samuel Dagogo-Jack, MD, DM, FRCP, discussed the recent study which sought to prove just that, called “Look AHEAD. ” This trial implimented lifestyle-intervention programs which were focused on helping patients with Type 2 diabetes lose weight.

While there were many benefits, the study did not show that weight loss lowers heart disease risk in type 2 diabetes management as predicted, which examined this topic for 11 years — the longest diabetes study that looked specifically at weight management to help prevent cardiovascular disease in patients with Type 2 diabetes.

What they did find was improvements in glycemic control, blood pressure, HDL cholestorol (or good cholestrol), sleep apnea, and many other health benefits by participating in a management program.

Dagogo-Jack says that interventions may have started too late or that it ended too early. In the future, they also want to consider how statin use affected the weight management and other risk-factors which may not have been considered. Dagogo-Jack  says the jury is still out and the importance of weight loss should not be dismissed. Stay tuned for additional data and in the meantime, “keep your health in check.”

Lifestyle Intervention Changes in Arab-Americans

Linda Jaber, PharmaD, presented on lifestyle changes which effectively helped Arab-Americas in her study with weight loss/management which is a key risk factor for Type 2 Diabetes. The educational intervention in an Arab-American population focused on educating around lifestyle intervention that was cultural sensitive and scalabile.

The education was group-delivered, family-centered and the strategies offered were culturally-specific and sensitive to the needs of the population. Another successful strategy was involving participants to act as coaches by sharing success stories with the group. Since a majority of the participants were Muslim, the education had specific strategies for fasting during Ramadan.

Many people met a 7 percent weight loss goal set by the study. By encouraging participants to reduce fat intake, they were able to reduce calories with simple modification of ethnic foods and portion control for participants. They also found that family support was a significant predictor of weight-loss support, 70 percent of people who achieved the weight-loss goal had family support.

In summary, a culturally-appropriate, group lifestyle intervention implemented in a community setting was feasible and effective in helping to prevent diabetes risk factors in Arab-American patients.

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