Changes in lifestyle can prevent diabetes in a decade

Undergoing modest weight loss of 10 years or less a drug against diabetes in this period can prevent, or incidence of type 2 diabetes in people at high risk of developing the disease is less, depending on the Prevention Program Diabetes Outcomes Study (DPPOS), a long-term follow-up to a landmark 2001 study for the prevention of diabetes. Jill Crandall, MD, associate clinical professor of medicine at the College of Medicine Albert Einstein of Yeshiva University, was principal investigator in the follow-up study, which appears online in the last issue of the British medical journal The Lancet.

The initial study ─ Diabetes Prevention Program (DPP) ─ was a large randomized study of 3234 people at high risk of developing diabetes. At the beginning of the study were all adults are overweight or obese, with high glucose levels. The researchers published the results of DPP in 2001 ─ a year earlier than planned because the results were so clear ─. After three years of changes in lifestyle intense (modest weight loss in conjunction with increased physical activity) reduced the rate of development of type 2 diabetes by 58 per cent compared to placebo. Metformin oral diabetes drugs (850 mg twice daily) reduced the rate of diabetes, disease of 31 percent compared to placebo.

Given these impressive results were based on only three years of data could not, researchers have determined how long the benefits would be. Interrupted after a bridge in seven months after the initial study, which began tracking DPPOS, participated with 88 percent of DPP volunteers. During the interval of the study, all participants learned the results and offered 16 sessions of education continue to work intensively to changes in lifestyle. The latest results, which in May a decade of commitment ─ three in the DPP, and seven show DPPOS ─ that produces lifestyle even a modest weight loss contribute significantly to prevent or delay diabetes in a long period.

Diagnosed, particularly for the 10 years spanning the DPP and DPPOS studies, the incidence of diabetes (speed ie at which new cases of diabetes were) will be reduced in the lifestyle group , with 34 percent compared to placebo. Be reduced for the group, the medication diabetes cons metformin diabetes incidence of 18 per cent. In other words, a group of lifestyle delay type 2 diabetes about four years, compared to placebo, the metformin group and delayed two years.

"The fact that we continue to delay and perhaps prevent diabetes in people at high risk of developing the disease, is certainly a positive outcome," said Mr. Crandall. It notes that these individuals were randomized to changes lifestyle was to make the risk factors more favorable cardiovascular (including reduction of blood pressure and triglycerides), despite a reduction of medication prescribed by their personal physician.

The benefits of changes in lifestyle intensive spoken mainly in the elderly. Persons aged 60 and older, the rate of type 2 diabetes reduced over the next 10 years by about half.

The increase in the number of overweight Americans has led to an epidemic of type 2 diabetes, no sign of slowing. Over two thirds of adults overweight or obese. About 11 percent of adults ─ ─ 24 million people suffer from diabetes, and up to 95 percent of them have type 2 diabetes, according to the National Institutes of Health. Diabetes is a major cause of heart disease and stroke and the main cause of kidney failure, amputations and blindness of recent onset.

The researchers now analyzing the data DPPOS see whether different clinical outcomes between the three groups. "The long-term loss of weight reduction and diabetes that we observed in DPPOS are encouraging," says Dr. Crandall. "But, ultimately establishing the benefits: prevention of diabetes, shows that deaths can be reduced and the serious complications that are associated with this disease."