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Issue 91 Item 1 Onset of Type 2 Diabetes Reduced 58% With Lifestyle Changes, Met

Feb 12, 2002

Treating IGT and IFG patients can both reduce the incidence of type 2 diabetes in high-risk men and women and delay the complications from diabetes  Impaired Fasting Glucose (IFG) is a fasting blood glucose of greater than 110 and less then 126mg/dl.  Both IGT and IFG are signs of high blood sugars, but not high enough to diagnose the patient with diabetes. 

Should IGT and IFG be designated as a disease so we can treat to target and prevent or delay the diagnosis of diabetes which would prevent or delay the complications from diabetes?????? Click here to reply

Dr. William C. Knowler from the Southwest American Indian Center for Diabetes Prevention, Phoenix, and colleagues with the Diabetes Prevention Program Research Group, studied 3232 nondiabetic men and women, mean age 51 years, with elevated fasting and post-load plasma glucose levels. Mean body mass index of the subjects was 34.0 kg/m .

The subjects were randomly assigned to placebo, metformin 850 mg twice daily, or to a lifestyle intervention program aimed at achieving at least a 7% reduction in weight and 150 minutes of physical activity per week.
During the average follow-up of 2.8 years the incidence of diabetes was 11.0 cases per 100 person-years in patients receiving placebo, 7.8 among those receiving metformin and 4.8 for those in the weight loss and exercise program, the researchers report.

The incidence of diabetes was reduced by 58% among those in the weight loss and exercise program and by 31% for those in the metformin group, compared with the placebo group. The lifestyle program was significantly more effective than metformin therapy in all age groups (p < 0.05), Dr. Knowler’s team notes.

Dr. Knowlers Team notes that,” it is not necessary to wait until a person has type 2 diabetes to begin doing something about it. The hope is that if we can provide some intervention at an early stage, before people have overt diabetes, they can avoid getting diabetes," he said.
"The lifestyle intervention was particularly effective, with one case of diabetes prevented per seven persons treated for 3 years,’ Dr. Knowler pointed out. "Thus, it should also be possible to delay or prevent the development of complications, substantially reducing the individual and public health burden of diabetes." N Engl J Med 2002;346:393-403.