It seems very logical that getting people to adopt healthy lifestyles–eat a good diet, get enough exercise, manage stress, avoid high-risk activities like smoking, drug use or too much alcohol intake–will both lower health spending and improve ultimate health outcomes. One expensive chronic condition is diabetes, which also can have an impact on the cardiovascular health of patients. Research reported in the New England Journal of Medicine suggests that an intensive lifestyle intervention for these patients did not improve cardiovascular outcomes. (NEJM Article) Analyzing over 5000 overweight patients with diabetes and following them for a very long period, a program of diet control and exercise was successful in producing greater weight loss, better glycemic control, better all-around fitness and better control of most cardiovascular risk factors, but was unsuccessful in reducing death from cardiovascular causes, nonfatal heart attacks, nonfatal stroke or hospitalizations for chest pain. The intervention patients also received significant counseling and support from providers. The loss of weight and the other improvements in health undoubtedly are important and almost certainly improve the quality of life for these patients. And the researchers did not compute economic outcomes, but you would suspect health utilization and spending was lower for the intervention group, perhaps enough to outweigh the cost of the intervention. It is unclear why rates of cardiovascular events were not different; perhaps more weight loss is needed or perhaps the control group had enough weight loss and health improvement to reduce their risks. But these interventions should not be abandoned just because they don’t appear to change some outcomes; they have other benefits that are worth pursuing.
Lifestyle Changes and Cardiovascular Outcomes for Patients with Diabetes
By Kevin RocheJuly 15, 2013Commentary
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
CVS has finalized its $10.6 billion buyout of Oak Street health, which operates primary care centers for Medicare members. People may think CVS is a drug store company, but it...
May 4, 2023
Option Care, a large home health care provider is acquiring Amedisys, another large player in that market, for $3.6 billion, as consolidation ramps up across health care, likely meaning higher...
May 4, 2023
Another example of over-priced companies trying to find some way to survive in the post-epidemic financial world. Transcarent, which does something, somehow to “access high quality, affordable care” is buying...
March 6, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace
May 30, 2023
The CV-19 and Vax Lies Continue
Three pieces of misleading research or at least reporting of research indicate why science is…
May 29, 2023
Expect More of This
Minnesota's suicide rate has risen by 40% in twenty years. Democrats have been in charge…
May 29, 2023
Some Quick Climate News
CO2 and temperature have a complex relationship and the Arctic isn't going through unprecendented warmth.