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Impact of Intensive Lifestyle Intervention on Depression and Health-Related Quality of Life in Type 2 Diabetes: The Look AHEAD Trial

2014; American Diabetes Association; Volume: 37; Issue: 6 Linguagem: Inglês

10.2337/dc13-1928

1935-5548

Richard R. Rubin, Thomas A. Wadden, Judy Bahnson, George L. Blackburn, Frederick L. Brancati, George A. Bray, Mace Coday, Scott J. Crow, Jeffrey M. Curtis, Gareth R. Dutton, Caitlin Egan, Mary E. Evans, Lin Ewing, Lucy F. Faulconbridge, John P. Foreyt, Sarah A. Gaussoin, Edward W. Gregg, Helen P. Hazuda, James O. Hill, Edward S. Horton, Van S. Hubbard, John M. Jakicic, Robert W. Jeffery, Karen Johnson, Steven E. Kahn, William C. Knowler, Wei Lang, Cora E. Lewis, Maria G. Montez, Anne Murillo, David M. Nathan, Jennifer Patricio, Anne L. Peters, Xavier Pi‐Sunyer, Henry J. Pownall, W. Jack Rejeski, Renate H. Rosenthal, Valerie Ruelas, Katie Toledo, Brent Van Dorsten, Mara Z. Vitolins, Donald Williamson, Rina R Wing, Jack A. Yanovski, Ping Zhang,

Pharmacology and Obesity Treatment

OBJECTIVE We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1–4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores. RESULTS ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75–0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores. CONCLUSIONS ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs.