Studies reveal the importance of lifestyle changes in preventing type 2 diabetes

by Sarita Sheth on October 22, 2012

A healthy body weight and moderate physical activity are important

Lifestyle changes are currently the most important theme in terms of preventing type 2 diabetes, according to the International Diabetes Federation.

It says that there is overwhelming evidence from studies in the United States, Finland, China, India and Japan that lifestyle changes including achieving a healthy body weight and moderate physical activity can help prevent the development of type 2 diabetes in those at high risk.

The new IDF strategy advocates that this should be the initial intervention for all people at risk of developing type 2 diabetes, as well as the focus of population health approaches.

There is growing evidence that earlier detection of individuals with IGT (impaired glucose tolerance) and others at high risk of developing diabetes, followed by interventions to delay or prevent type 2 diabetes and improve glucose control, can result in clinically important reductions in the incidence of diabetes and its complications and co-morbidities.

One of the earliest lifestyle intervention studies for the prevention of type 2 diabetes was done in a study of men aged 47 to 49 in Malmö, Sweden.

Men who took part in a lifestyle programme had a lower incidence of type 2 diabetes, and had a greater reversal of glucose intolerance compared to men who received the usual care.

The Da Qing Study in China looked at the effect of a six year diet and exercise programme in IGT men with an average age of 45. Diet change alone was associated with a 31% reduction, and exercise produced a 46% reduction in the risk of developing type 2 diabetes.

A Finnish Diabetes Prevention Study, which was the first randomised controlled trial to specifically examine the effect of a lifestyle intervention in preventing type 2 diabetes, looked at 522 overweight/obese people some who underwent lifestyle changes and a control group. The lifestyle programme included counselling focused on achieving and maintaining healthy body weight, reducing fat intake, increasing fibre intake and increasing physical activity. After two years the incidence of type 2 diabetes in the intervention group was less than half that of the control group.

One of the largest randomised controlled clinical trials to date is the Diabetes Prevention Programme involving 3,234 US adults with glucose intolerance. Unlike most previous studies, the cohort was diverse of which 68% were women and 45% ethnic minorities. It compared lifestyle changes, the use of the drug metformin and a placebo control group.

Both lifestyle intervention and metformin had positive effects on the prevention of type 2 diabetes and restoring normal glucose tolerance. However, the lifestyle intervention was more effective in preventing type 2 diabetes, particularly in older adults.

A recent paper relating to the DPP concluded that an increase in physical activity helps sustain weight loss and independently reduces diabetes risk among those who do not lose weight.

A programme in India looked at whether the progression to diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than other populations already studied.

Both lifestyle changes and metformin significantly reduced the incidence of diabetes in Asian Indians with IGT. The relative risk reduction was 28.5% with lifestyle modification, 26.4% with metformin and 28.2% with lifestyle modification combined with metformin.

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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