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2009/10/29
Based on original reporting by HealthDay News
(HealthDay News) - Diet and exercise can keep diabetes at bay for a decade, cutting the risk for the disease by more than a third in the most susceptible people, a new study finds.
New research, published in the Oct. 29 online edition of The Lancet, shows that losing weight and exercising can delay or prevent the onset of diabetes more effectively than the prescription drug metformin or a placebo.
"Interventions that result in weight loss lower the risk of diabetes, and that lower risk appears to persist for a long period of time," said study author Dr. William C. Knowler of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
For people who are at high risk of getting diabetes, losing weight "is clearly to be recommended," he said. In addition, using a drug like metformin may also benefit people unable to lose weight through exercise and diet alone, he said.
For the diabetes prevention study, 3,234 overweight or obese adults with elevated blood sugar levels were randomly assigned to either lifestyle changes or metformin to control their blood sugar, or a placebo.
After 10 years, 2,766 remained in the trial, and those taking metformin saw an 18 per cent reduction in their rate of developing diabetes, compared with those on placebo.
But those who had made lifestyle changes - reducing caloric and fat intake and exercising at least 150 minutes a week - reduced their risk of getting diabetes by 34 per cent compared with those on placebo, the researchers found.
Over 10 years, after all the participants made lifestyle changes, the yearly diabetes incidence rates for the drug and placebo groups had dropped to about 5 to 6 per cent, the same rate as the lifestyle group.
"Lifestyle intervention, even when provided later, also seemed to lower diabetes incidence rate," Knowler said.
Dr. Anoop Misra, director of the department of diabetes and metabolic diseases at Fortis Hospitals in India, and author of an accompanying journal editorial, said that "prevention of diabetes is important to curb epidemic of diabetes globally. Diet and exercise remain the most important modalities to prevent diabetes, and any drugs are less important."
At-risk groups of diabetes need to be identified, especially certain ethnic groups, and taught proper lifestyle management strategies, Misra said. "Young adults with family history of diabetes should be carefully managed along the same lines," he said.
Diabetes prevention makes economic sense as well, by decreasing costly, lifelong expenditures on management of the disease and its complications, Misra said.
Regarding the study findings, other experts are optimistic. Dr. Ronald Goldberg, a professor of medicine at the Diabetes Research Institute of the University of Miami Miller School of Medicine, whose institution participated in the study, said that " lifestyle works, and every effort needs to be made to begin and maintain a lifestyle program in the long-term."
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