The Effects of an Intensive Lifestyle Intervention for Type 2 Diabetes on Disability Insurance
Condition: Diabetes Mellitus Type 2
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Observational

Summary: 
      Starting in 2001, the Look AHEAD study randomized patients with type 2 diabetes to an
      intensive lifestyle intervention (ILI) focused on weight loss versus a control group
      receiving diabetes education ("Diabetes Support and Education"). The ILI successfully reduced
      weight, improved diabetes control, and functional status, among other outcomes. In this
      study, the investigators will compare participation in federal disability insurance programs
      between the ILI and the control group during and after the intervention period (2001-2017).
    

Detailed description: 
      Starting in 2001, the Look AHEAD study randomized 5145 patients with type 2 diabetes to an
      intensive lifestyle intervention (ILI) focused on weight loss versus a control group
      receiving diabetes education ("Diabetes Support and Education").The Look AHEAD study tested
      whether participants with type 2 diabetes assigned to an intensive lifestyle intervention
      (ILI) for weight loss exhibited reductions in cardiovascular morbidity and mortality,
      relative to a control group receiving usual care and diabetes support and education. During
      the 12-year intervention period, the ILI led to persistent reductions in weight, waist
      circumference, and hemoglobin A1c and improvements in physical fitness, among other clinical
      benefits. After the conclusion of the intervention in 2012, participants were consented to be
      linked with administrative data. The investigators attempted to link 3188 consenting
      participants with Social Security Administration databases. Of these, the investigators were
      able to successfully link 3093 participants. In this study, the investigators will compare
      participation in federal disability insurance programs including Social Security Disability
      Insurance (SSDI) and disability-related Supplemental Security Income (SSI) between the linked
      ILI and the control group during and after the intervention period (2001-2017). The
      investigators will investigate ILI-versus-control differences in whether participants ever
      applied or received benefits from SSDI and SSI. The investigators will also investigate
      ILI-versus-control differences in applications and benefit receipt in each year after
      randomization, relative to a pre-randomization assessment period. The investigators will use
      both multivariate regression controlling for baseline participant characteristics and clinic
      site and also survival analyses that estimate whether the time until SSDI or SSI application
      or benefit receipt differs between the ILI and control groups.
    

Intervention name(s): Intensive lifestyle intervention (ILI); Diabetes support and education (DSE)
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Lifestyle intervention focused on weight loss through diet and physical activity; Behavioral intervention focused on diabetes support and education
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        The study population includes Look AHEAD participants that consented to administrative data
        linkages, provided individual identifiers that could be linked with SSA data, and were
        successfully linked to SSA data.