For adults with impaired glucose tolerance, a six-year lifestyle intervention program reduces cardiovascular and all-cause mortality, and diabetes, according to a study published in The Lancet Diabetes & Endocrinology.

Guangwei Li, M.D., from the China-Japan Friendship Hospital in Beijing, and colleagues conducted a cluster randomized trial involving 33 clinics in Da Qing, China, serving 577 adults with impaired glucose tolerance. The authors sought to examine the long-term effect of lifestyle intervention.

Participants were randomized in a 1:1:1:1 ratio to a control group (138 participants) or lifestyle intervention groups (diet, exercise, or both; 439 participants). The intervention phase lasted six years from 1986, and participants were followed-up in 2009. The analyses included data from 568 patients.

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During 23 years of follow-up, the researchers found that 174 participants died (121 in intervention groups and 53 in the control group). The cumulative incidence of cardiovascular mortality was significantly reduced in the intervention group versus the control group (11.9 versus 19.6 percent; hazard ratio, 0.59; P = 0.033).

All-cause mortality was also significantly lower in the intervention group (28.1 versus 38.4 percent; hazard ratio, 0.71; P = 0.049). The incidence of diabetes was 72.6 percent in the intervention group, compared with 89.9 percent in the control group (hazard ratio, 0.55; P = 0.001).

“These findings emphasize the long-term clinical benefits of lifestyle intervention for patients with impaired glucose tolerance and provide further justification for adoption of lifestyle interventions as public health measures to control the consequences of diabetes,” the authors write.