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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 C; 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.
Afiliación
  • Espeland MA; Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC mespelan@wakehealth.edu.
  • Glick HA; Weight and Eating Disorder Program, University of Pennsylvania, Philadelphia, PA.
  • Bertoni A; Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC.
  • Brancati FL; Johns Hopkins School of Medicine, Baltimore, MD.
  • Bray GA; Pennington Biomedical Research Center, Baton Rouge, LA.
  • Clark JM; Johns Hopkins School of Medicine, Baltimore, MD.
  • Curtis JM; Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Shiprock, NM.
  • Egan C; Weight Control and Diabetes Research Center, Brown Medical School/The Miriam Hospital, Providence, RI.
  • Evans M; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
  • Foreyt JP; Department of Medicine, Baylor College of Medicine, Houston, TX.
  • Ghazarian S; Roybal Comprehensive Health Center, Los Angeles, CA.
  • Gregg EW; Centers for Disease Control and Prevention, Atlanta, GA.
  • Hazuda HP; University of Texas Health Science Center at San Antonio, San Antonio, TX.
  • Hill JO; Anschutz Health and Wellness Center, University of Colorado Health Sciences Center, Aurora, CO.
  • Hire D; Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
  • Horton ES; Department of Clinical Epidemiology, Joslin Diabetes Center, Boston, MA.
  • Hubbard VS; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
  • Jakicic JM; Diabetes Unit, Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
  • Jeffery RW; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
  • Johnson KC; Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN.
  • Kahn SE; Department of Medicine, University of Washington, Seattle, WA.
  • Killean T; Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Shiprock, NM.
  • Kitabchi AE; Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN.
  • Knowler WC; Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ Southwest American Indian Center, National Institute of Diabetes and Digestive and Kidney Diseases, Shiprock, NM.
  • Kriska A; Diabetes Unit, Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA.
  • Lewis CE; Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL.
  • Miller M; Anschutz Health and Wellness Center, University of Colorado Health Sciences Center, Aurora, CO.
  • Montez MG; University of Texas Health Science Center at San Antonio, San Antonio, TX.
  • Murillo A; Department of Medicine, University of Washington, Seattle, WA.
  • Nathan DM; Massachusetts General Hospital, Boston, MA.
  • Nyenwe E; Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN.
  • Patricio J; Division of and Department of Medicine, St. Luke's-Roosevelt Hospital, New York, NY.
  • Peters AL; Roybal Comprehensive Health Center, Los Angeles, CA.
  • Pi-Sunyer X; Division of and Department of Medicine, St. Luke's-Roosevelt Hospital, New York, NY.
  • Pownall H; Department of Medicine, Baylor College of Medicine, Houston, TX.
  • Redmon JB; Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
  • Rushing J; Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
  • Ryan DH; Pennington Biomedical Research Center, Baton Rouge, LA.
  • Safford M; Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL.
  • Tsai AG; Division of Internal Medicine, University of Colorado Health Sciences Center, Aurora, CO.
  • Wadden TA; Weight and Eating Disorder Program, University of Pennsylvania, Philadelphia, PA.
  • Wing RR; Weight Control and Diabetes Research Center, Brown Medical School/The Miriam Hospital, Providence, RI.
  • Yanovski SZ; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
  • Zhang P; Centers for Disease Control and Prevention, Atlanta, GA.
Diabetes Care ; 37(9): 2548-56, 2014 Sep.
Article en En | MEDLINE | ID: mdl-25147253
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Costos de la Atención en Salud / Diabetes Mellitus Tipo 2 / Sobrepeso / Servicios de Salud / Estilo de Vida / Obesidad Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Care Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Costos de la Atención en Salud / Diabetes Mellitus Tipo 2 / Sobrepeso / Servicios de Salud / Estilo de Vida / Obesidad Tipo de estudio: Clinical_trials / Etiology_studies / Health_economic_evaluation / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Diabetes Care Año: 2014 Tipo del documento: Article Pais de publicación: Estados Unidos