The Long-Term Benefits of Interventions to Improve T2D Outcomes

项目摘要/摘要 糖尿病是一个日益严重的公共卫生问题，每年新增病例数以百万计。控制不好的糖尿病是 与严重的健康并发症有关，包括心脏病、失明和截肢。控制 糖尿病可以通过坚持饮食、锻炼和治疗指南来实现，但遵守 处方疗法可能是复杂和困难的。前瞻性研究随机化了一项密集的 2001年，生活方式干预的重点是减轻5000多名2型糖尿病患者的体重。 在11年的时间里，参与干预的参与者减肥并改善了他们对糖尿病的控制 干预组相对对照组。体重减轻和糖尿病结局的改善可能会导致 为患者在功能状态、工作能力和更少的健康并发症方面带来更广泛的好处。我们 建议进行研究，将前瞻性参与者与联邦医疗保险和社会保障的数据联系起来 用于确定干预措施对长期医疗保健利用的影响的管理(例如医院 入院)、就业、收入、退休和严重残疾(以残疾登记人数衡量 保险)。此外，我们将模拟更广泛的、全国性的经济扩张对财政的长期影响 强化生活方式干预。最后，我们将比较Look收集的健康和残疾衡量标准 对医疗保险和社会保障管理数据中重叠措施的前瞻性研究，以进行评估 在临床试验中使用管理数据作为健康信息的来源。这项研究的结果将 为成功的糖尿病生活方式干预的更广泛益处提供重要证据。在……里面 此外，结果将表明糖尿病控制的改善对功能状态和经济状况的影响 结果。

Project Summary/ Abstract Diabetes is a mounting public health concern, with millions of new cases each year. Poor control of diabetes is associated with serious health complications, including heart disease, blindness, and amputation. Control of diabetes can be achieved through adherence to diet, exercise, and treatment guidelines, but compliance with prescribed regimens can be complicated and difficult. The Look AHEAD study randomized an intensive lifestyle intervention focused on weight reduction among over 5,000 patients with type 2 diabetes in 2001. Participants in the intervention lost weight and improved their diabetes control over the 11 years of the intervention relative to the control group. Weight reductions and improvements in diabetes outcomes may lead to broader benefits for patients in terms of functional status, ability to work, and fewer health complications. We propose research linking Look AHEAD participants with data from Medicare and the Social Security Administration to determine the effect of the intervention on long-term health care utilization (e.g. hospital admissions), employment, earnings, retirement, and severe disability (as measured by enrollment in disability insurance). In addition, we will simulate the long-term fiscal impacts of a broader, national expansion of the intensive lifestyle intervention. Finally, we will compare health and disability measures collected by the Look AHEAD study to overlapping measures in Medicare and the Social Security Administration data, to evaluate the use of administrative data as a source of health information in clinical trials. The results of this study will provide important evidence on the broader benefits of successful lifestyle interventions for diabetes. In addition, the results will indicate the impact of improved diabetes control on functional status and economic outcomes.