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Issue 95 Item 13 Evidence for Prevention of Diabetes – Reduce the Risk by 71%

Study shows a decrease in the incidence of developing type 2 diabetes by 71% Two recent studies have shown that type 2 diabetes can be prevented by lifestyle interventions in subjects who are at high risk for diabetes. In the Finland Diabetes Prevention Study, published in May 2001, 522 overweight subjects with impaired glucose tolerance were randomly assigned to an intervention or control group. The intervention group received individualized counseling to reduce weight (seven sessions the first year and every 3 months for the remainder of study), to decrease intake of total and saturated fat, and to increase intake of fiber and physical activity. Subjects were followed for 3.2 years and received an oral glucose tolerance test (OGTT) annually. Results at the end of 1 year showed a weight loss of 4.2 and 0.8 kg for the intervention and control groups, respectively. The incidence of diabetes after 4 years was 11% in the intervention group and 23% in the control group. During the study, the risk of diabetes was reduced by 58% in the intervention group.

The initial results of a similar study, the Diabetes Prevention Program (DPP), a multicenter National Institutes of Health study, suggest that type 2 diabetes can be prevented and delayed. The DPP was a randomized trial involving more than 3,200 adults who were >25 years of age and who were at increased risk of developing type 2 diabetes (i.e., having impaired glucose tolerance, being overweight, and having a family history of type 2 diabetes). The study involved a control group (standard care plus a placebo pill) and two intervention groups: one that received a intensive lifestyle modification (healthy diet, moderate physical activity of 30 min/day for 5 days/week) and one that received standard care plus an oral diabetes agent (Metformin). The major study findings indicate that participants in the intensive lifestyle modification group reduced their risk of developing diabetes by 58% compared with the medication intervention group who reduced their risk by 31%. Even more dramatic was the finding that individuals over 60 years of age in the intensive lifestyle modification group decrease their incidence of developing type 2 diabetes by 71%. Diabetes Care 25:608-613, 2002