African Americans and Hispanics with type 2 diabetes have worse glycemic control relative to non-Hispanic whites. The Look AHEAD randomized trial demonstrated that an intensive lifestyle intervention for weight loss (ILI), versus diabetes support and education (DSE), improved HbA1c among overweight/obese adults with type 2 diabetes. We examined whether ILI reduced racial/ethnic disparities in achieving optimal glycemic control (HbA1c <7%). We used a GEE model to examine the effects of race/ethnicity, treatment arm, and their interaction on achieving HbA1c <7% over 8 years. Among 4,889 participants (16% African American, 14% Hispanic), more achieved HbA1c <7% in ILI vs. DSE in years 1-4 (p<0.001). However, significantly fewer Hispanic and African Americans achieved HbA1c <7% (p<0.001). The race by treatment interaction was not significant at any time point. These findings demonstrate persistent racial/ethnic disparities in glycemic control in a clinical trial population over eight years, which were not reduced by an effective lifestyle intervention. More research is needed to develop interventions that improve diabetes outcomes while reducing disparities.
J.F. Hayes: None. A. Bertoni: None. S.J. Pilla: None. R.R. Wing: None.
National Institutes of Health