Abstract 1298: Impact of Lifestyle Intervention on Health-related Quality of Life in Subjects at High-risk for Diabetes
Adults with impaired glucose tolerance (IGT) may have reduced health-related quality of life (HRQoL), particularly in relation to their ability to perform physical activities. To assess changes in HRQoL after intentional weight loss, through intensive lifestyle intervention (ILS) or metformin treatment (MET) compared to placebo (PLB), we evaluated 3234 overweight/obese participants with IGT from the Diabetes Prevention Program using the 36-Item Short-Form (SF-36) health survey physical (PCS) and mental (MCS) component summaries and domains. Baseline overall (SF-6D) scores were similar across treatment groups: 80.2 in ILS, 79.8 in MET, and 80.1 in PLB participants (p=0.6). After a mean follow-up of 3.2 years, there were significant improvements in the overall (+0.84, p<0.04) and PCS (+1.57, p<0.0001) scores in ILS compared to those in the PLB group, but not in MET participants (+0.19 and +0.15, respectively p=0.6). Specifically, ILS participants showed improvements in general health (+3.2, p<0.001), physical function (+3.6, p<0.001), bodily pain (+1.9, p=0.01), and vitality (+2.1, p=0.01) scores. When potential predictors were added sequentially, the treatment effects remained significant after adjusting for baseline demographic factors (age, sex, and race/ethnicity), medical (hypertension, dyslipidemia, and history of myocardial infarction/stroke) and psychological (anxiety & depression) comorbidities. Increased physical activity and weight reduction appear to mediate these ILS treatment effects. No benefits with ILS or MET were observed in the MCS score. These results suggest that overweight/obese adults at high-risk for diabetes show significant improvement in most physical HRQoL and vitality scores through the weight loss and increased physical activity achieved with an ILS intervention.