期刊
DIABETES CARE
卷 41, 期 5, 页码 1040-1048出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc17-2110
关键词
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资金
- National Institutes of Health (NIH)
- National Institute of Diabetes and Digestive and Kidney Diseases [DK-57136, DK-57149, DK-56990, DK-57177, DK-57171, DK-57151, DK-57182, DK-57131, DK-57002, DK-57078, DK-57154, DK-57178, DK-57219, DK-57008, DK-57135, DK-56992]
- National Heart, Lung, and Blood Institute
- National Institute of Nursing Research
- National Center on Minority Health and Health Disparities
- NIH Office of Research on Women's Health
- Centers for Disease Control and Prevention
- National Institute of Diabetes and Digestive and Kidney Diseases
- Johns Hopkins Medical Institutions Bayview General Clinical Research Center [M01-RR-02719]
- Massachusetts General Hospital Mallinckrodt General Clinical Research Center
- Massachusetts Institute of Technology General Clinical Research Center [M01-RR-01066]
- Harvard Clinical and Translational Science Center [RR-025758-04]
- University of Colorado Health Sciences Center General Clinical Research Center [M01-RR-00051]
- Clinical Nutrition Research Unit [P30-DK-48520]
- University of Tennessee at Memphis General Clinical Research Center [M01-RR-0021140]
- University of Pittsburgh General Clinical Research Center [M01-RR-000056]
- University of Pittsburgh Clinical and Translational Research Center - Clinical and Translational Science Award [UL1-RR-024153]
- NIH [DK-046204]
- Wake Forest Clinical and Translational Science Institute [UL1-TR-001420]
- VA Puget Sound Health Care System Medical Research Service, Department of Veterans Affairs
- Frederic C. Bartter General Clinical Research Center [M01-RR-01346]
OBJECTIVE The impact of weight loss intervention on disability-free life expectancy in adults with diabetes is unknown. We examined the impact of a long-term weight loss intervention on years spent with and without physical disability. RESEARCH DESIGN AND METHODS Overweight or obese adults with type 2 diabetes age 45-76 years (n = 5,145) were randomly assigned to a 10-year intensive lifestyle intervention (ILI) or diabetes support and education (DSE). Physical function was assessed annually for 12 years using the 36-Item Short Form Health Survey. Annual incidence of physical disability, mortality, and disability remission were incorporated into a Markov model to quantify years of life spent active and physically disabled. RESULTS Physical disability incidence was lower in the ILI group (6.0% per year) than in the DSE group (6.8% per year) (incidence rate ratio 0.88 [95% CI 0.81-0.96]), whereas rates of disability remission and mortality did not differ between groups. ILI participants had a significant delay in moderate or severe disability onset and an increase in number of nondisabled years (P < 0.05) compared with DSE participants. For a 60-year-old, this effect translates to 0.9 more disability-free years (12.0 years [95% CI 11.5-12.4] vs. 11.1 years [95% CI 10.6-11.7]) but no difference in total years of life. In stratified analyses, ILI increased disability-free years of life in women and participants without cardiovascular disease (CVD) but not in men or participants with CVD. CONCLUSIONS Long-term lifestyle interventions among overweight or obese adults with type 2 diabetes may reduce long-term disability, leading to an effect on disability-free life expectancy but not on total life expectancy.
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