Lifestyle changes effective in preventing type 2 diabetes, international study finds

by Barbara Hewitt on May 22, 2014

Lifestyle change is more effective in preventing type 2 diabetes than focussing on genetic risk, a new international study has found.

According to the study led by the Medical Research Council Epidemiology Unit at the University of Cambridge, combating the growth of the condition comes down to having effective public health strategies in place.

Lifestyle change is the most effective strategy in preventing type 2 diabetes

Over 380 million people worldwide are estimated to be affected by diabetes, with serious consequences for the health and economy of both developed and developing countries.

Type 2 diabetes is thought to originate from a complex interplay of a large number of genetic risk variants and lifestyle factors, such as diet and exercise.

It is well known that lifestyle interventions can reduce the risk of developing diabetes in high risk individuals by 50%; however, there has also been a debate over whether there is value in targeted lifestyle interventions according to a person’s genetic susceptibility.

In an attempt to find out more, the researchers calculated a genetic risk score for type 2 diabetes study participants based on which of 49 known genetic variants for the disease each person carried, Individuals were then divided into four equally sized groups from lowest to highest genetic risk score.

Researchers then examined the combined effects of the genetic score and lifestyle factors on the development of diabetes for 12,403 middle aged people with type 2 diabetes and 16,154 people in a control group.

Findings indicated that the percentage of people of normal weight who developed type 2 diabetes over a 10 year period varied between 0.25% for those with the lowest genetic risk to 0.89% for those with the greatest genetic risk.

In obese people, these figures ranged from 4.22% to 7.99%. In other words, obese individuals had the highest risk of developing type 2 diabetes, regardless of their genetic risk score, emphasising the role of lifestyle as being much more important in the development of the disease than genetics.

‘We have known for a long time that there is no single cause for type 2 diabetes. It’s a complex interaction of dozens of genes and our lifestyles. Recent genetic breakthroughs have provided the promise of targeted lifestyle interventions based on a person’s genetic make-up. However, genetic risk factors are greatly outweighed by lifestyle factors,’ said Professor Nick Wareham, director of the MRC Epidemiology Unit.

‘We need effective strategies in place if we are going to stem the rapid rise in the number of cases of type 2 diabetes and the burden this places on our health systems. Our research suggests that focusing on tackling the lifestyle factors that lead to obesity at a population level will have a much greater impact than tailoring prevention strategies according to an individual’s genetic risk,’ he added.

According to professor David Lomas, chair of the MRC’s Population and Systems Medicine Board, one of the most effective ways to reduce the impact of type 2 diabetes is to stop people developing the condition in the first place.

‘This large international study reinforces the idea that broad promotion of a healthy diet and lifestyle is the way to go. Genomic information has already given us important insights into the diabetes disease mechanism, and grouping patients based on their genes and other biological factors still holds a great deal of promise for directing more targeted treatments for type 2 diabetes,’ he said.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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