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Reasons to recommend lifestyle changes in type 2 diabetes mellitus and obesity

Nature Reviews Cardiology volume 10, page 678 (2013)Cite this article

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In her Research Highlight (Diabetes: Look AHEAD published: weight loss not linked to fewer cardiovascular events in patients with type 2 diabetes. Nat. Rev. Cardiol. 10, 429 [2013]),1 Bryony M. Mearns focuses on data from the randomized, multicentre Look AHEAD study,2 where intensive lifestyle modifications were not linked to fewer cardiovascular events during a 10-year follow-up period in patients with type 2 diabetes mellitus and obesity. This finding has important implications in various clinical fields, including cardiology, endocrinology, and nephrology. Clinicians often suggest lifestyle modifications with the aim of reducing coronary heart disease. On the basis of the new evidence, the question arises whether lifestyle modifications, such as weight loss, should still be recommended in the absence of a demonstrated reduction in cardiovascular events. As a clinician with a particular interest in cardiology, endocrinology, and nephrology, I would still suggest lifestyle modifications for three reasons.

First, the reduction of cardiovascular events is not the only reason that clinicians suggest lifestyle modifications. An equally important reason is to prevent end-stage renal disease, which is linked to obesity, hypertension, and type 2 diabetes,3,4 and has not been addressed in the Look AHEAD study.2

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References

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  1. Department of Internal Medicine I (Endocrinology, Heidelberg University Hospital, Nephrology, Osteology) and Clinical Chemistry, Im Neuenheimer Feld 410, 69210, Heidelberg, Germany

    Rainer Spiegel

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  1. Rainer Spiegel
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Correspondence to Rainer Spiegel.

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Spiegel, R. Reasons to recommend lifestyle changes in type 2 diabetes mellitus and obesity. Nat Rev Cardiol 10, 678 (2013). https://doi.org/10.1038/nrcardio.2013.101-c1

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