A study published online today and in an upcoming edition of The Lancet provides evidence that intensive lifestyle changes aimed at modest weight loss and increased physical activity continue to reduce the rate of developing type 2 diabetes after 10 years. Results from the Diabetes Prevention Program Outcomes Study (DPPOS) indicate that lifestyle intervention reduced the onset of type 2 diabetes by 34 percent compared with placebo.

According to the study, participants initially randomized to the lifestyle intervention group also had more favorable cardiovascular risk factors, such as lower blood pressure and triglyceride levels, even though they were taking fewer drugs to control their risk for heart disease.

Additionally, participants randomly assigned to take the oral diabetes drug metformin during the original study reduced the rate of developing type 2 diabetes by 18 percent over 10 years compared with placebo. Participants in the lifestyle changes group were able to delay the onset of type 2 diabetes by about four years on average while the metformin group delayed the disease by two years compared with placebo.

DPPOS is the long-term follow-up study to the landmark Diabetes Prevention Program (DPP), a randomized clinical trial that found the lifestyle intervention reduced the incidence of type 2 diabetes in high-risk adults by 58 percent over 2.8 years while metformin reduced the risk by 31 percent compared with placebo. In DPPOS, the investigators examined the persistence of these effects over the next 10 years.

"These results clearly advance our reasons to make lifestyle intervention a high priority for people who are at high risk for type 2 diabetes," commented R. Paul Robertson, MD, President, Medicine & Science of the American Diabetes Association. "It is our hope that health care professionals will translate the findings of this study to further motivate patients make changes in their diet and physical activity to lower their risk."

Lifestyle changes have long been recommended by the American Diabetes Association, which provided research funding co-support to the NIH-funded DPP and DPPOS, to prevent or delay the onset of type 2 diabetes. These changes include being mindful about healthy food choices, reducing fat and calorie intake to reduce weight by 5-7% if you are overweight, and being physically active, such as by walking for 30 minutes a day 5 or more times per week. For people who are at high risk for type 2 diabetes, the following steps are especially important to consider when making these lifestyle changes:

- Are you at risk for diabetes?
- Are you ready, able and willing to change your lifestyle habits?
- What lifestyle habits are you ready, able and willing to change?
- What are realistic expectations for each goal that you have set?

The American Diabetes Association also provides a Diabetes Risk Test to calculate an individual's personal risk for type 2 diabetes at http://www.diabetes.org/risk.

Nearly 24 million Americans have diabetes, a group of serious diseases characterized by high blood glucose levels that result from defects in the body's ability to produce and/or use insulin. Diabetes can lead to severely debilitating or fatal complications, such as heart disease, blindness, kidney disease, and amputations. It is a leading cause of death by disease in the United States. More than 57 million have pre-diabetes, a condition of high risk for diabetes, and could potentially benefit from prevention efforts.

Source
American Diabetes Association