Looking AHEAD to Reduce Knee Pain

The Look AHEAD (Action for Health in Diabetes) Trial is a large ongoing prospective trial on the long-term effect of weight management on outcomes in people with type 2 diabetes.

A paper just released online in the journal OBESITY features an article by Capri Foy and colleagues from the Look AHEAD trialists on the impact of intensive lifestyle intervention on physical function and knee pain.

The paper focuses on the 2,203 participants, who reported knee pain at baseline.

The intensive lifestyle intervention arm of the trial includes behavioural interventions as well as the intermittent use of meal replacements and pharmacotherapy to control weight. The control arm of the trial uses conventional diabetes management strategies.

The participants in the intensive intervention arm experienced and almost 10% mean weight loss compared to virtually no change in the control group.

This reduction in body weight over 12 months was associated with a significant and clinically relevant improvement in pain and function of the participants.

A separate analysis demonstrated that apart from the weight loss itself, part of the improvement in pain and functioning was mediated by increased fitness in the intervention group.

The authors conclude that the intensive lifestyle intervention focussing on weight loss in adults with type 2 diabetes and knee pain, results in significant improvement in physical function.

As reported previously, it should be noted that overall the participants in the intensive intervention group also experienced a remarkable improvement in their diabetes control.

Although findings from clinical trials cannot necessarily be extrapolated to usual practice, these findings certainly highlight that a far greater emphasis on weight management will likely benefit patients with type 2 diabetes – benefits that go well beyond simply improving glycemic control.

Edmonton, Alberta

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Foy CG, Lewis CE, Hairston KG, Miller GD, Lang W, Jakicic JM, Rejeski WJ, Ribisl PM, Walkup MP, & Wagenknecht LE (2010). Intensive Lifestyle Intervention Improves Physical Function Among Obese Adults With Knee Pain: Findings From the Look AHEAD Trial. Obesity (Silver Spring, Md.) PMID: 20559303