Rena Wing and colleagues plan to recruit 5,000 people nationwide who have type 2 diabetes.
If some studies suggest that diabetics who lose weight die sooner, then what do you tell overweight diabetics who want to shed pounds?
Rena Wing will try to answer that question over the next 12 years. On June 25, she launched a $180-million nationwide study of whether weight loss in people with type 2 diabetes decreases risk for heart disease, stroke and death.
"There is a lot of evidence showing that weight loss has beneficial effects on diabetes and heart disease in the short term, but there is almost no data on the long-term effects of weight loss," said study co-director Wing, professor of psychiatry and human behavior. "Some studies have found that diabetics who lose weight live longer, yet other studies suggest they die sooner. Results of previous studies may be inconsistent because we don’t know why or how people lost this weight."
The project is the largest study on the effects of weight-loss interventions ever funded by the National Institutes of Health. Type 2 diabetes has reached epidemic status in the United States due primarily to the increasing incidence of obesity and an aging population. Between 1976 and 1994, the incidence of diabetes among middle-aged people increased by 38 percent nationwide. About 80 percent of type 2 diabetics are overweight or obese. About 40,000 people in Rhode Island have type 2 diabetes.
"Getting people to lose weight is talked about as the best treatment for both preventing diabetes in people who are overweight and for treating individuals who already have the disease," said Wing, who is based at The Miriam Hospital, one of the project’s 16 study sites. "If the long-term data from the study support these approaches, it will make it easier to go to patients, insurance companies and public-policy makers and say, ‘Yes, weight loss works over the long run.’"
Wing and colleagues plan to recruit 5,000 people nationwide. Individuals between ages 45 and 75 who have type 2 diabetes and are considered overweight or obese are eligible. Study leaders hope to enroll equal numbers of men and women, with one-third from ethnic minority groups. A disproportionate number of minorities are affected by diabetes.
Anyone interested in enrolling may call 793-5599 or visit the study's online site.
People who qualify for the study will be randomly assigned to either an intensive weight loss program or to a diabetes support and education program. The weight loss program uses diet and exercise to help participants lose at least 7 to 10 percent of their initial weight. Participants in the diabetes support and education program will attend sessions on nutrition and physical activity and meet in support groups.
Individuals will be followed up to 11.5 years. The researchers will examine how the interventions affect diabetes control, heart attack, stroke and cardiovascular disease — the primary illnesses associated with being overweight — and other markers of general health. Quality-of-life indicators, such as job and home-life satisfaction, will also be examined.
All interventions and associated medical tests will be free. Results will be provided to participants and their physicians.
Wing directs the Weight Control and Diabetes Research Center at The Miriam Hospital. She is also a professor of psychiatry, psychology and epidemiology at the University of Pittsburgh.
The study’s other co-director is F. Xavier Pi-Sunyer, M.D. He directs the Obesity Research Center at St. Luke’s-Roosevelt Hospital Center in New York and the New York Obesity and Nutrition Research Center.
Primary funding for the project comes from NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.