Intensive lifestyle intervention for Type 2 diabetes associated with increased employment

When individuals with Type 2 diabetes received intensive lifestyle intervention in multiple areas,  including sessions with lifestyle counselors, dietitians and other specialists, they were more likely to lose weight and improve diabetes control, while being less likely to experience disability and diabetes complications. 

New research published in JAMA Internal Medicine, led by the University of Minnesota School of Public Health (SPH), the University of Southern California Schaeffer Center for Health Policy & Economics, and the Wake Forest School of Medicine, suggests these benefits could translate to increased employment. 

The research team studied participants at 16 different U.S. sites in the Look AHEAD trial, which included more than 5,000 people with Type 2 diabetes who were also classified as overweight or obese. Participants were randomly assigned to either intensive lifestyle intervention or a control group receiving diabetes support and education. The trial ran between 2001 to 2012 and previously demonstrated the intervention group experienced reduced weight, improved diabetes control, and reduced disability and diabetes complications when compared to the control group.

The research team built on these findings through a novel approach that linked data from consenting participants to data from the Social Security Administration on employment, earnings and participation in Social Security disability insurance programs. 

The researchers found:

• Compared to the control group, employment increased for intensive lifestyle intervention participants by 4% overall.
• Employment increased by 7% for participants with education that did not include a college degree. There were no statistically significant effects for earnings or disability receipt.
• There were no statistically significant effects for earnings or disability receipt. 

“Linking clinical trials and economic data advances our understanding of the relationship between socio-economic status and health,” said lead author Peter Huckfeldt, SPH’s Vernon E. Weckwerth Professor in Healthcare Administration Leadership. “Previous research has shown the link between better in utero and childhood health and economic outcomes later in life, so it is exciting to now see those same connections may extend to improved health later in life.”

Additionally, these results imply better management of chronic diseases could improve labor market outcomes, which should be considered when evaluating interventions aimed at improving chronic conditions. The research team is continuing to follow this cohort, to better understand the long-term effects of the intervention — and related improvements in diabetes management — on health and functional status. 

This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute on Aging.