Cardiovascular Effects of Intensive Lifestyle Intervention in Type 2 Diabetes

Weight loss is recommended for overweight or obese patients with type 2 diabetes.1 This recommendation is based on short-term studies showing numerous benefits of weight loss, including improvements in glycemic control, risk factors for cardiovascular disease, quality of life, and other obesity-related coexisting illnesses.2 However, it is unknown whether weight loss reduces the risk of cardiovascular morbidity and mortality in patients with type 2 diabetes. Epidemiologic studies involving patients with diabetes have had conflicting results, perhaps because of confounding from unintentional weight loss.3 A meta-analysis4 of cohort studies concluded that moderate intentional weight loss was associated with reduced mortality among . . .