The Long-Term Benefits of Interventions to Improve T2D Outcomes

项目总结/摘要 糖尿病是一个日益严重的公共卫生问题，每年有数百万新病例。糖尿病控制不佳是 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 规定的治疗方案可能复杂而困难。Look AHEAD研究随机分配了一个密集的 2001年，生活方式干预的重点是减轻5 000多名2型糖尿病患者的体重。 在11年的干预中，参与者体重减轻，糖尿病控制得到改善。 相对于对照组的干预。体重减轻和糖尿病结局的改善可能导致 在功能状态、工作能力和更少的健康并发症方面为患者带来更广泛的益处。我们 建议将Look AHEAD参与者与Medicare和Social Security的数据联系起来 管理，以确定干预对长期卫生保健利用的影响（例如，医院 入学），就业，收入，退休和严重残疾（通过残疾登记来衡量） 保险）。此外，我们还将模拟更广泛的国家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收集的健康和残疾指标 AHEAD研究医疗保险和社会保障管理局数据中的重叠措施，以评估 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 为糖尿病成功的生活方式干预的更广泛益处提供了重要证据。在 此外，研究结果将表明改善糖尿病控制对功能状态和经济的影响。 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.