Physical Activity and Weight Control Delay Diabetes Onset

A follow-up of a major study has shown that the protective effects of both lifestyle intervention and treatment with metformin last as long as 10 years.

Researchers affiliated with the Diabetes Prevention Program (DPP) at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK; Phoenix, AZ, USA) conducted an extended follow-up of most of the patients from the original DPP study, published in 2002, that compared an intensive lifestyle intervention program with metformin or placebo in 3,234 nondiabetic patients with elevated fasting glucose and impaired glucose tolerance. At the time, the rate of new diabetes fell by 58% with intensive lifestyle intervention and by 31% with metformin only, compared with placebo, over a mean period of 2.8 years. The original study found that compared with metformin, lifestyle intervention, which included diet modification, exercise, and weight-reduction targets, lowered the new diabetes rate by 39%.

The recent 10-year follow up analysis shows that compared to the nonintervention group, patients in the intensive lifestyle intervention group and metformin group, respectively, were 34% and 18% less likely to develop diabetes over 10 years, even after regaining most of the weight initially lost. The benefits of intensive lifestyle intervention were particularly strong in the elderly; those aged 60 and older in the diet and exercise group lowered their rate of developing diabetes by half over 10 years. The researchers will continue to follow the study participants for at least another five years; one goal of the continued follow-up is to determine the impact of the lifestyle and drug interventions on the development of diabetes complications, such as nerve damage and blindness. The study was published online on October 29, 2009, in The Lancet.

"Weight loss is still the most important thing we have to recommend to overweight people at risk for type 2 diabetes,” said lead author William Knowler, M.D., director of the NIDDK. "This study shows that the benefits of even modest weight loss can persist for many years.”

Related Links:
National Institute of Diabetes and Digestive and Kidney Diseases