Association of Lifestyle Intervention With Risk for Cardiovascular Events Differs by Level of Glycated Hemoglobin
Authors' conclusion
Among adults with type 2 diabetes and overweight/obesity, randomization to a lifestyle intervention was differentially associated with CVD risk by baseline HbA1c such that it was associated with lower risk at lower HbA1c levels and higher risk at higher HbA1c levels. There is a critical need to develop and tailor lifestyle interventions to be successful for individuals with type 2 diabetes and high HbA1c.
Study context
- Population
- Adults aged 45 to 76 years with T2D and overweight/obesity; mean baseline HbA1c 7.3% (SD 1.2)
- Participants
- 5,145 adults
- Comparison
- Intensive lifestyle intervention vs diabetes support and education
- Primary endpoint
- Parent trial's primary composite CVD outcome, by baseline HbA1c
- Follow-up
- Median 9.6 years
Methodological detailssubgroup analysis by baseline HbA1c quintile
- Subgroup analysis by baseline HbA1c quintile
Primary result
As reported in the abstract
Composite CVD outcome by baseline HbA1c quintile
ILI vs DSEHazard ratio (95% CI)
HbA1c quintile 1
0.68(0.53–0.88)
HbA1c quintile 2
0.80(0.66–0.96)
HbA1c quintile 5
1.27(1.02–1.58)
- Additive and multiplicative heterogeneity of the intensive lifestyle intervention (ILI)–cardiovascular disease (CVD) association by baseline HbA1c
- all P < .001
Original publication
Association of Lifestyle Intervention With Risk for Cardiovascular Events Differs by Level of Glycated Hemoglobin. J Clin Endocrinol Metab. Published 18 November 2023. doi:10.
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