Healthy Lifestyle Choices Can Reduce Diabetes Risk

Today’s fast-paced world leaves people little time to worry about their health—that is, until a medical emergency forces them to reassess their habits. That’s when it becomes apparent how much influence lifestyle choices have on our quality of life. For example, each day in the U.S., more than 4,000 people are diagnosed with type 2 diabetes, a chronic condition marked by high levels of blood glucose that can lead to serious complications and premature death. And while there is no cure for the disease, it can be managed by eating healthy foods, exercising, maintaining a healthy weight and, if needed, medications or insulin therapy to regulate blood sugar levels. But researchers say these same healthy lifestyle choices can also significantly delay or perhaps even prevent type 2 diabetes, even for those who are at high risk for the disease.

The latest evidence comes from a follow-up study on 3,234 overweight or obese adults with elevated blood glucose levels who participated in the Diabetes Prevention Program (DPP), a three-year randomized trial completed in 2001. Initial DPP results showed that the program, which consisted of reducing fat and calories, increasing physical activity to 150 minutes a week, and frequent interaction with health-care professionals who provided training in diet, exercise and behavior modification, reduced the development of type 2 diabetes by 58 percent. Those assigned to two daily doses of metformin, an oral diabetes medication, but no lifestyle changes reduced the development of the disease by 31 percent over the same period, compared to those assigned a placebo.

Results from the Diabetes Prevention Program Outcomes Study (DPPOS), which included 2,766 of the DPP participants, shows that the diet and exercise group not only cut their risk of developing diabetes by 34 percent over a 10-year period, but also sustained a moderate weight loss and had lower blood pressure and triglyceride levels. People over 60 got even more dramatic results, cutting their risk of diabetes during the study period by about half. The group initially assigned metformin and later added in the lifestyle program had an 18 percent lower risk of developing diabetes. “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.

Knowler acknowledges that losing weight is a difficult task and can’t be accomplished simply by telling people to slim down. “To make things like this happen on a large scale, we have to do more than simply tell people to lose weight,” he said, adding that people need access to weight loss clinics that can teach them about diet and exercise.

“When you consider the devastating medical complications that go with type 2 diabetes, these are very significant findings,” said Dr. Ronald Goldberg, principal investigator of the University of Miami Miller School of Medicine arm of the study. “It demonstrates that lifestyle changes can last as long as 10 years in preventing or slowing diabetes in people who are at risk.” Dr. Griffin Rodgers, director of the National Institute of Diabetes and Digestive and Kidney Diseases, agrees, saying that “millions of people could delay diabetes for years and possibly prevent the disease altogether if they lost a modest amount of weight through diet and increased physical activity.”

Dr. Anoop Misra, director of the department of diabetes and metabolic diseases at Fortis Hospitals in New Delhi, India, and author of an accompanying journal editorial, says the study shows that lifestyle intervention is “the best bet” for effectively preventing diabetes. “Diet and exercise remain the most important modalities to prevent diabetes, and any drugs are less important.”

Misra says all nations should take steps to help curb the diabetes epidemic, such as regulating the advertisement and sale of “energy-dense junk food to children” and encouraging regular physical activity starting at an early age. “Spreading awareness about proper lifestyle and adverse consequences of obesity and diabetes should be at the top of health agenda of all nations.”

The results of the DPPOS study are published in the October 29 online edition of The Lancet.