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(Wake Forest University), Henry A. Glick(University of Pennsylvania), Alain G. Bertoni(Wake Forest University), Frederick L. Brancati(Johns Hopkins University), George A. Bray(Pennington Biomedical Research Center), Jeanne M. Clark(Johns Hopkins University), Jeffrey M. Curtis(American Indian Center), Caitlin Egan(Miriam Hospital), Mary E. Evans(National Institutes of Health), John P. Foreyt(Baylor College of Medicine), Siran Ghazarian, Edward W. Gregg(Centers for Disease Control and Prevention), Helen P. Hazuda(The University of Texas at San Antonio Health Science Center), James O. Hill(University of Colorado Health), Don Hire(Wake Forest University), Edward S. Horton(Joslin Diabetes Center), Van S. Hubbard(National Institutes of Health), John M. Jakicic(University of Pittsburgh), Robert W. Jeffery(University of Minnesota), Karen Johnson(University of Tennessee Health Science Center), Steven E. Kahn(University of Washington), Tina Killean(American Indian Center), Abbas E. Kitabchi(University of Tennessee Health Science Center), William C. Knowler(American Indian Center), Andrea M. Kriska(University of Pittsburgh), Cora E. Lewis(University of Alabama at Birmingham), Marsha Miller(University of Colorado Health), Maria G. Montez(The University of Texas at San Antonio Health Science Center), Anne Murillo(University of Washington), David M. Nathan(Massachusetts General Hospital), Ebenezer A. Nyenwe(University of Tennessee Health Science Center), Jennifer Patricio(St. Luke's-Roosevelt Hospital Center), Anne L. Peters, Xavier Pi‐Sunyer(St. Luke's-Roosevelt Hospital Center), Henry J. Pownall(Baylor College of Medicine), J. Bruce Redmon(University of Minnesota), Julia Rushing(Wake Forest University), Donna H. Ryan(Pennington Biomedical Research Center), Monika M. Safford(University of Alabama at Birmingham), Adam Gilden Tsai(University of Colorado Health), Thomas A. Wadden(University of Pennsylvania), Rena R. Wing(Miriam Hospital), Susan Z. Yanovski(National Institutes of Health), Ping Zhang(Centers for Disease Control and Prevention)
Diabetes Care
August 7, 2014
10.2337/dc14-0093
Cited by 174Open Access
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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.

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