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

被引：138

作者：

Espeland, Mark A. ^{[1
]}

Glick, Henry A. ^{[2
]}

Bertoni, Alain ^{[3
]}

Brancati, Frederick L. ^{[4
]}

Bray, George A. ^{[5
]}

Clark, Jeanne M. ^{[4
]}

Curtis, Jeffrey M. ^{[6
]}

Egan, Caitlin ^{[7
]}

Evans, Mary ^{[8
]}

Foreyt, John P. ^{[9
]}

Ghazarian, Siran ^{[10
]}

Gregg, Edward W. ^{[11
]}

Hazuda, Helen P. ^{[12
]}

Hill, James O. ^{[13
]}

Hire, Don ^{[1
]}

Horton, Edward S. ^{[14
]}

Hubbard, Van S. ^{[8
]}

Jakicic, John M. ^{[15
]}

Jeffery, Robert W. ^{[16
]}

Johnson, Karen C. ^{[17
]}

Kahn, Steven E. ^{[18
]}

Killean, Tina ^{[6
]}

Kitabchi, Abbas E. ^{[17
]}

Knowler, William C. ^{[6
]}

Kriska, Andrea ^{[15
]}

Lewis, Cora E. ^{[19
]}

Miller, Marsha ^{[13
]}

Montez, Maria G. ^{[12
]}

Murillo, Anne ^{[18
]}

Nathan, David M. ^{[20
]}

Nyenwe, Ebenezer ^{[17
]}

Patricio, Jennifer ^{[21
]}

Peters, Anne L. ^{[10
]}

Pi-Sunyer, Xavier ^{[21
]}

Pownall, Henry ^{[9
]}

Redmon, Bruce ^{[16
]}

Rushing, Julia ^{[1
]}

Ryan, Donna H. ^{[5
]}

Safford, Monika ^{[19
]}

Tsai, Adam G. ^{[22
]}

Wadden, Thomas A. ^{[2
]}

Wing, Rena R. ^{[7
]}

Yanovski, Susan Z. ^{[8
]}

Zhang, Ping ^{[11
]}

机构：

[1] Wake Forest Sch Med, Dept Biostat Sci, Winston Salem, NC 27157 USA

[2] Univ Penn, Weight & Eating Disorder Program, Philadelphia, PA 19104 USA

[3] Wake Forest Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC USA

[4] Johns Hopkins Sch Med, Baltimore, MD USA

[5] Pennington Biomed Res Ctr, Baton Rouge, LA 70808 USA

[6] NIDDK, Southwest Amer Indian Ctr, Phoenix, AZ USA

[7] Miriam Hosp, Brown Med Sch, Weight Control & Diabet Res Ctr, Providence, RI 02906 USA

[8] NIDDK, NIH, Bethesda, MD USA

[9] Baylor Coll Med, Dept Med, Houston, TX 77030 USA

[10] Roybal Comprehens Hlth Ctr, Los Angeles, CA USA

[11] Ctr Dis Control & Prevent, Atlanta, GA USA

[12] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

[13] Univ Colorado, Hlth Sci Ctr, Anschutz Hlth & Wellness Ctr, Aurora, CO USA

[14] Joslin Diabet Ctr, Dept Clin Epidemiol, Boston, MA 02215 USA

[15] Univ Pittsburgh, Diabet Unit, Dept Hlth & Phys Act, Pittsburgh, PA USA

[16] Univ Minnesota, Div Epidemiol & Community Hlth, Minneapolis, MN USA

[17] Univ Tennessee, Ctr Hlth Sci, Dept Prevent Med, Memphis, TN 38163 USA

[18] Univ Washington, Dept Med, Seattle, WA USA

[19] Univ Alabama Birmingham, Birmingham, AL USA

[20] Massachusetts Gen Hosp, Boston, MA 02114 USA

[21] St Lukes Roosevelt Hosp, Div Dept Med, New York, NY 10025 USA

[22] Univ Colorado, Hlth Sci Ctr, Div Internal Med, Aurora, CO USA

来源：

DIABETES CARE | 2014年 / 37卷 / 09期

关键词：

DISEASE RISK-FACTORS; WEIGHT-LOSS; MELLITUS; INDIVIDUALS; SAVINGS;

D O I：

10.2337/dc14-0093

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：2548 / 2556

页数：9

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