Diet, Lifestyle Modifications Prevent Diabetes
Adults at risk of developing diabetes may prevent the disease by making changes in lifestyle that include increased exercise, weight loss, and a more healthful diet, according to a recent study published in the New England Journal of Medicine.1
People in the study were identified as being at risk for adult onset (type 2) diabetes if impaired blood sugar control was detected, either by elevated fasting blood sugar levels or high blood sugar levels following administration of a drink high in glucose. While not serious enough to warrant a diabetes diagnosis, impaired blood sugar control is associated with an increased risk of developing the disease later on.
Each person was then randomly assigned one of three interventions: standard diet and lifestyle recommendations plus a medication, standard diet and lifestyle recommendations plus a placebo, or extensive diet and lifestyle recommendations. The standard recommendations were given in half an hour, and included instructions to eat a low-fat diet, lose weight, and exercise regularly.
The extensive recommendations were given over a 16-lesson period. During these sessions, participants were counseled to lose 7% or more of their body weight; to exercise moderately for 30 minutes, five times per week; and to eat a healthful, low-calorie, low-fat diet. After these initial 16 visits, participants receiving intensive counseling were given monthly follow-up meetings to ensure compliance with the program.
Roughly half the people in the intensive counseling group met the weight loss and exercise suggestions made by instructors. In the groups that only received half an hour of counseling, little or no change in weight or exercise habits was noted.
More striking was the fact that weight loss, a more healthful diet, and moderate exercise decreased the incidence of diabetes. After three years in the study, the incidence of diabetes was 58% lower among participants who underwent the multi-visit counseling than in those who received standard counseling and placebo.
The oral medication, metformin, also reduced the incidence of diabetes compared with the placebo. However, the incidence of diabetes was 39% less in participants assigned to the intensive lifestyle modification program than in those assigned to metformin plus standard lifestyle recommendations.
Type 2 diabetes affects roughly 8% of adult Americans.2 Currently, there is no known way to prevent juvenile-onset, or type 1, diabetes, although there is some evidence that avoiding cow's milk may be protective.3
Recent interest in preventing adult-onset diabetes has grown as the incidence of the disease continues to increase worldwide. Researchers have started to focus on those adults with pre-diabetic warning signs, such as obesity, impaired blood sugar control, and insulin resistance. This study adds to the findings of three earlier studies showing that improved diet, regular exercise, and weight loss can dramatically decrease the risk of type 2 diabetes.4 5 6
1. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393–403.
2. Harris MI, Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults: the Third National Health and Nutrition Examination Survey, 1988–1994. Diabetes Care 1998;21:518–24.
3. Elliott RB, Harris DP, Hill JP, et al. Type I (insulin-dependent) diabetes mellitus and cow milk: casein variant consumption. Diabetologia 1999;42:292–6.
4. Eriksson KF, Lindgarde F. Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise: the 6-year Malmo feasibility study. Diabetologica 1991;34:891–8.
5. Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343–50.
6. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. Diabetes Care 1997;20:537–44.
Matt Brignall, ND, is in practice at the Seattle Cancer Treatment and Wellness Center and at the Evergreen Integrative Medicine Clinic in Kirkland, WA. He specializes in integrative treatment of cancer. He is a contributor to Healthnotes and Healthnotes Newswire.
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