Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: The action for health in diabetes

Mark A. Espeland, Henry A. Glick, Alain Bertoni, Frederick L. Brancati, George A. Bray, Jeanne M. Clark, Jeffrey M. Curtis, Caitlin Egan, Mary Evans, John P. Foreyt, Siran Ghazarian, Edward W. Gregg, Helen P. Hazuda, James O. Hill, Don Hire, Edward S. Horton, Van S. Hubbard, John M. Jakicic, Robert W. Jeffery, Karen C. JohnsonSteven E. Kahn, Tina Killean, Abbas E. Kitabchi, William C. Knowler, Andrea Kriska, Cora E. Lewis, Marsha Miller, Maria G. Montez, Anne Murillo, David M. Nathan, Ebenezer Nyenwe, Jennifer Patricio, Anne L. Peters, Xavier Pi-Sunyer, Henry Pownall, J. Bruce Redmon, Julia Rushing, Donna H. Ryan, Monika Safford, Adam G. Tsai, Thomas A. Wadden, Rena R. Wing, Susan Z. Yanovski, Ping Zhang

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial. RESEARCH DESIGN AND METHODS A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years. RESULTS: ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P < 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P < 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385-7,175); however, these were not evident among individuals with a history of cardiovascular disease. CONCLUSIONS: Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs.

Original languageEnglish (US)
Pages (from-to)2548-2556
Number of pages9
JournalDiabetes care
Volume37
Issue number9
DOIs
StatePublished - Sep 2014

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

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    Espeland, M. A., Glick, H. A., Bertoni, A., Brancati, F. L., Bray, G. A., Clark, J. M., Curtis, J. M., Egan, C., Evans, M., Foreyt, J. P., Ghazarian, S., Gregg, E. W., Hazuda, H. P., Hill, J. O., Hire, D., Horton, E. S., Hubbard, V. S., Jakicic, J. M., Jeffery, R. W., ... Zhang, P. (2014). Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: The action for health in diabetes. Diabetes care, 37(9), 2548-2556. https://doi.org/10.2337/dc14-0093