Lifestyle Changes Can Postpone Diabetes

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In a 20-year study, active intervention lowered incidence by 43%.

SAN FRANCISCO—New data suggest that group-based lifestyle interventions followed for longer than six years can postpone or prevent development of type 2 diabetes for up to 20 years.

That conclusion is based on data from individuals enrolled in the China Da Qing Diabetes Prevention Trial, which was begun in 1986 and conducted in 33 clinics. Researchers randomly assigned 577 adults with impaired glucose tolerance to one of three lifestyle intervention groups (diet alone, exercise alone, or diet plus exercise) or to a control group. Active intervention over six years led to a 31-46% decreased incidence of diabetes regardless of initial body mass.

“Lifestyle interventions appear to be a justifiable and necessary public health action, both in developed and developing countries,” said investigator Guangwei Li, MD, a diabetologist at China-Japan Friendship Hospital, in Beijing.

Dr. Li and colleagues conducted a 20-year follow-up study to assess the long-term effects of lifestyle intervention on the subsequent risk of diabetes beyond the period of active intervention. The study also looked at the incidence of CVD events, CVD mortality, and all-cause mortality.

For the primary analyses, the investigators combined the three intervention groups a priori because there were no significant differences in diabetes incidence among the groups during the active intervention phase and because it would have been difficult to demonstrate statistical significance.

Over 20 years of follow-up, diabetes developed in 80% of the intervention group compared with 93% of controls. After adjusting for age and clustering by clinic, the intervention group had a 43% lower incidence, the study found. In addition, participants assigned to the intervention group had a mean of 3.6 fewer years with diabetes.

The investigators, who reported study findings here at the American Diabetes Association annual meeting, observed no significant difference between the combined intervention groups and control group in the risk of CVD events, CVD mortality, or all-cause mortality.

Study findings support the use of lifestyle changes in the prevention of diabetes, Dr. Li said. He emphasized, however, that “whether lifestyle interventions aimed at preventing diabetes also reduce CVD and mortality in patients with impaired glucose tolerance remains uncertain.”

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