Racial/ethnic and socioeconomic disparities in weight outcomes, cardiovascular events, and mortality in the look AHEAD trial. (October 2022)

• Record Type: Journal Article
• Authors: Cromer, Sara J.; Meigs, James; Wexler, Deborah J.
• Is Part Of: Diabetes research and clinical practice. Volume 192(2022)
• Publication Date: 2022-10
• Subjects: Lifestyle intervention -- Race/ethnicity -- Socioeconomic status -- Health disparity; T2D type 2 diabetes -- ILII intensive lifestyle intervention -- DSE diabetes support and education -- Look AHEAD Action for Health in Diabetes -- HS high school -- SES socioeconomic status; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.110095
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Background: Intensive lifestyle interventions (ILI) for type 2 diabetes (T2D) improve health outcomes, but participants from different races/ethnicities or socioeconomic status may not benefit equally. Methods: Within the Look AHEAD trial, we examined achievement of the 7% weight loss goal, as well as secondary weight, cardiovascular, and mortality outcomes, by race/ethnicity and educational attainment (EA). Results: Among 4, 640 participants (31 % Black or Hispanic, 13 % with less than a high school degree), Black and Hispanic participants were less likely than White participants to achieve 7 % weight loss in both the ILI (45.8 % v. 60.7 %, p < 0.001 and 53.0 % v. 60.7 %, p = 0.01, respectively) and diabetes support and education (DSE) arms. Contrastingly, participants with less than a high school degree were more likely in the ILI but less likely in the DSE arm to achieve this goal, with a significant arm by EA interaction. Hispanic participants and those with lowest EA also experienced decreased mortality in the ILI versus the DSE arm. Conclusions: All Look AHEAD participant subgroups achieved greater weight loss from ILI; however, Black and Hispanic participants lost less weight than White participants in both arms, while those with lowest EA benefited disproportionately from the ILI compared to participants with higher EA.