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, Henry A. Glick, Alain Bertoni, Frederick L. Brancati, George A. Bray, Jeanne M. Clark, Jeffrey M. Curtis, Caitlin Egan, Mary Evans, John P. Foreyt, Siran Ghazarian, Edward W. Gregg, Helen P. Hazuda, James O. Hill, Don Hire, Edward S. Horton, Van S. Hubbard, John M. Jakicic, Robert W. Jeffery, Karen Johnson & 24 others Steven E. Kahn, Tina Killean, Abbas E. Kitabchi, William C. Knowler, Andrea Kriska, Cora E. Lewis, Marsha Miller, Maria G. Montez, Anne Murillo, David M. Nathan, Ebenezer Nyenwe, Jennifer Patricio, Anne L. Peters, Xavier Pi-Sunyer, Henry Pownall, J. Bruce Redmon, Julia Rushing, Donna H. Ryan, Monika Safford, Adam G. Tsai, Thomas A. Wadden, Rena R. Wing, Susan Z. Yanovski, Ping Zhang

Research output: Contribution to journalArticle

85 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)2548-2556
Number of pages9
JournalDiabetes care
Volume37
Issue number9
DOIs
StatePublished - Jan 1 2014

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Type 2 Diabetes Mellitus
Life Style
Costs and Cost Analysis
Health
Hospitalization
Cost Savings
Health Care Costs
Education
Health Services
Weight Loss
Research Design
Cardiovascular Diseases

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

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. / Espeland, Mark A.; Glick, Henry A.; Bertoni, Alain; Brancati, Frederick L.; Bray, George A.; Clark, Jeanne M.; Curtis, Jeffrey M.; Egan, Caitlin; Evans, Mary; Foreyt, John P.; Ghazarian, Siran; Gregg, Edward W.; Hazuda, Helen P.; Hill, James O.; Hire, Don; Horton, Edward S.; Hubbard, Van S.; Jakicic, John M.; Jeffery, Robert W.; Johnson, Karen; Kahn, Steven E.; Killean, Tina; Kitabchi, Abbas E.; Knowler, William C.; Kriska, Andrea; Lewis, Cora E.; Miller, Marsha; Montez, Maria G.; Murillo, Anne; Nathan, David M.; Nyenwe, Ebenezer; Patricio, Jennifer; Peters, Anne L.; Pi-Sunyer, Xavier; Pownall, Henry; Redmon, J. Bruce; Rushing, Julia; Ryan, Donna H.; Safford, Monika; Tsai, Adam G.; Wadden, Thomas A.; Wing, Rena R.; Yanovski, Susan Z.; Zhang, Ping.

In: Diabetes care, Vol. 37, No. 9, 01.01.2014, p. 2548-2556.

Research output: Contribution to journalArticle

Espeland, MA, Glick, HA, Bertoni, A, Brancati, FL, Bray, GA, Clark, JM, Curtis, JM, Egan, C, Evans, M, Foreyt, JP, Ghazarian, S, Gregg, EW, Hazuda, HP, Hill, JO, Hire, D, Horton, ES, Hubbard, VS, Jakicic, JM, Jeffery, RW, Johnson, K, Kahn, SE, Killean, T, Kitabchi, AE, Knowler, WC, Kriska, A, Lewis, CE, Miller, M, Montez, MG, Murillo, A, Nathan, DM, Nyenwe, E, Patricio, J, Peters, AL, Pi-Sunyer, X, Pownall, H, Redmon, JB, Rushing, J, Ryan, DH, Safford, M, Tsai, AG, Wadden, TA, Wing, RR, Yanovski, SZ & Zhang, P 2014, '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', Diabetes care, vol. 37, no. 9, pp. 2548-2556. https://doi.org/10.2337/dc14-0093
Espeland, Mark A. ; Glick, Henry A. ; Bertoni, Alain ; Brancati, Frederick L. ; Bray, George A. ; Clark, Jeanne M. ; Curtis, Jeffrey M. ; Egan, Caitlin ; Evans, Mary ; Foreyt, John P. ; Ghazarian, Siran ; Gregg, Edward W. ; Hazuda, Helen P. ; Hill, James O. ; Hire, Don ; Horton, Edward S. ; Hubbard, Van S. ; Jakicic, John M. ; Jeffery, Robert W. ; Johnson, Karen ; Kahn, Steven E. ; Killean, Tina ; Kitabchi, Abbas E. ; Knowler, William C. ; Kriska, Andrea ; Lewis, Cora E. ; Miller, Marsha ; Montez, Maria G. ; Murillo, Anne ; Nathan, David M. ; Nyenwe, Ebenezer ; Patricio, Jennifer ; Peters, Anne L. ; Pi-Sunyer, Xavier ; Pownall, Henry ; Redmon, J. Bruce ; Rushing, Julia ; Ryan, Donna H. ; Safford, Monika ; Tsai, Adam G. ; Wadden, Thomas A. ; Wing, Rena R. ; Yanovski, Susan Z. ; Zhang, Ping. / 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. In: Diabetes care. 2014 ; Vol. 37, No. 9. pp. 2548-2556.
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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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T1 - Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes

T2 - The action for health in diabetes

AU - Espeland, Mark A.

AU - Glick, Henry A.

AU - Bertoni, Alain

AU - Brancati, Frederick L.

AU - Bray, George A.

AU - Clark, Jeanne M.

AU - Curtis, Jeffrey M.

AU - Egan, Caitlin

AU - Evans, Mary

AU - Foreyt, John P.

AU - Ghazarian, Siran

AU - Gregg, Edward W.

AU - Hazuda, Helen P.

AU - Hill, James O.

AU - Hire, Don

AU - Horton, Edward S.

AU - Hubbard, Van S.

AU - Jakicic, John M.

AU - Jeffery, Robert W.

AU - Johnson, Karen

AU - Kahn, Steven E.

AU - Killean, Tina

AU - Kitabchi, Abbas E.

AU - Knowler, William C.

AU - Kriska, Andrea

AU - Lewis, Cora E.

AU - Miller, Marsha

AU - Montez, Maria G.

AU - Murillo, Anne

AU - Nathan, David M.

AU - Nyenwe, Ebenezer

AU - Patricio, Jennifer

AU - Peters, Anne L.

AU - Pi-Sunyer, Xavier

AU - Pownall, Henry

AU - Redmon, J. Bruce

AU - Rushing, Julia

AU - Ryan, Donna H.

AU - Safford, Monika

AU - Tsai, Adam G.

AU - Wadden, Thomas A.

AU - Wing, Rena R.

AU - Yanovski, Susan Z.

AU - Zhang, Ping

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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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