Importance of Fitness and Weight Loss in Obese Diabetics
Improving fitness and losing weight help overweight diabetes patients slow their decline in mobility, according to ongoing Look AHEAD (Action for Health in Diabetes) study published in the New England Journal of Medicine.
Age often results in reduced mobility. The situation is worse if the patient suffers from diabetes as well. Being overweight further worsens the problem. Reduced mobility affects the independence of an individual and the quality of life in general.
A study was conducted to assess if intentional weight loss and improved fitness could reduce the chances of immobility in overweight people with diabetes over a period of 4 years.
The study was conducted in more than 5000 overweight or obese individuals with type 2 diabetes. The participants were between the ages of 45 and 74 years. They were divided into 2 groups: the first group received an intensive lifestyle intervention, while the second group received a diabetes support-and-education program. The aim in the first group was to bring about a mean weight loss of more than 7% and to increase the duration of physical activity to more than 175 minutes a week. The second group underwent three group sessions a year on nutrition, physical activity and support. The participants were assessed every year for a period of 4 years.
Mobility was assessed based on ratings from the participants regarding their ability to carry out activities that varied in intensity. Weight was assessed annually and a treadmill test was done at the baseline and at the end of years 1 and 4.
The study found that participants of the intensive lifestyle intervention program had a 48% reduction in the risk for mobility-related disability compared to those in the diabetes support-and-education group. Participants in the intervention group also reported a slightly less incidence of severe disability and a slightly higher incidence of good mobility.
The reduction in risk of mobility-related disability in the intensive lifestyle intervention group was due to both, weight loss and improvement in fitness. Weight loss helps to improve strength in the lower limbs and facilitate balance, which in turn improve mobility. The degree of weight loss was found to be related to adherence to diet.
The study thus reiterates the importance of fitness and weight loss in overweight diabetes patients.
1. Lifestyle Change and Mobility in Obese Adults with Type 2 Diabetes; Jack Rejeski et al; N Engl J Med 2012; 366:1209-1217