Lifestyle Counseling and Long-term Clinical Outcomes in Patients With Diabetes

Diabetes Care. 2019 Sep;42(9):1833-1836. doi: 10.2337/dc19-0629. Epub 2019 Aug 1.


Objective: To investigate the relationship between lifestyle counseling in primary care settings and clinical outcomes in patients with diabetes.

Research design and methods: We retrospectively studied hyperglycemic adults with diabetes treated at primary care practices between 2000 and 2014. We analyzed the relationship between frequency of lifestyle counseling (identified using natural language processing of electronic notes) and a composite outcome of death and cardiovascular events during subsequent follow-up.

Results: Among patients with monthly counseling or more, 10-year cumulative incidence of the primary outcome was 33.0% compared with 38.1% for less than monthly counseling (P = 0.0005). In multivariable analysis, higher frequency of lifestyle counseling was associated with lower incidence of the primary outcome (hazard ratio 0.88 [95% CI 0.82-0.94]; P < 0.001).

Conclusions: More frequent lifestyle counseling was associated with a lower incidence of cardiovascular events and death among patients with diabetes.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Counseling / statistics & numerical data*
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / etiology
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus / therapy*
  • Female
  • Humans
  • Incidence
  • Life Style
  • Male
  • Middle Aged
  • Primary Health Care / methods*
  • Retrospective Studies
  • Time Factors