Lifestyle Interventions Over 6 Years Prevents or Delays Diabetes 14-20 Years

They found that compared with control participants, those in the combined lifestyle intervention groups had a 51% lower incidence of diabetes during the study and 43% lower incidence over a 20 year period.

Intensive lifestyle interventions can reduce the incidence of type 2 diabetes in people with impaired glucose tolerance, but how long these benefits extend beyond the period of active intervention, and whether such interventions reduce the risk of cardiovascular disease (CVD) and mortality, is unclear. The researchers from China, the USA and Switzerland aimed to assess whether intensive lifestyle interventions have a long-term effect on the risk of diabetes, diabetes- related macrovascular and microvascular complications, and mortality. In 1986, 577 adults with impaired glucose tolerance from 33 clinics in China were randomly assigned to either the control group or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). Active intervention took place over 6 years until 1992. In 2006, study participants were followed-up to assess the long-term effect of the interventions.

They found that compared with control participants, those in the combined lifestyle intervention groups had a 51% lower incidence of diabetes (hazard rate ratio HRR 0·49) during the active intervention period and a 43% lower incidence (0·57) over the 20 year period, controlled for age and clustering by clinic. The average annual incidence of diabetes was 7% for intervention participants versus 11% in control participants, with 20-year cumulative incidence of 80% in the intervention groups and 93% in the control group. Participants in the intervention group spent an average of 3·6 fewer years with diabetes than those in the control group. There was no significant difference between the intervention and control groups in the rate of first CVD events (HRR 0·98), CVD mortality (0·83), and all- cause mortality (0·96), but our study had limited statistical power to detect differences for these outcomes.

The researchers concluded: "Group-based lifestyle interventions over 6 years can prevent or delay diabetes for up to 14 years after the active intervention. However, whether lifestyle intervention also leads to reduced CVD and mortality remains unclear."

The Lancet24 May 2008 Volume 371 Issue 9626 Pp 1783-1789 The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Prof Guangwei Li MD, Dr Ping Zhang PhD, Jinping Wang MD et al.

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