I just saw dr Anne Peters talking on Medscape why the Look AHEAD trial was stopped:
http://www.medscape.com/viewarticle/772429?src=mp&spon=38
As a reminder, the trial failed to show over a period of 11 years that modest weight loss and exercise can decrease CV events and death in patients with type 2 DM. There were some benefits however, like less OSA and urinary incontinence, slower decline in mobility in overweight adults. Further analysis of data from the trial are still underway. In general there were few CV events in both groups.
It seems like another thing taken for granted in medicine is not that clear-cut when tested under the scrutiny of a RCT or is it? What is important to note, patients in the control group did not gain weight and actually lost some weight (1%), also in general the groups were fairly well-controlled in terms of their diabetes (A1c 7.3%) and lipids (LDL 112 mg/dL) comparing to a significant number of patients we see. Should the population studied be different? If somebody starts with an A1c of 7.3% and with weight loss and exercise is able to get it down to lets say 6.9%, do we think it make a difference in her CV outcomes.
What also is noticeable is the amount of weight loss the intervention group was able to achieve with this considerable amount of help - 8.6% in the first year, which was not sustained and stayed at about 5% for the rest of the study. Losing weight is very hard!
