Specifically, for the 10 years spanning the DPP and DPPOS studies, the diabetes incidence (i.e., rate at which new diabetes cases were diagnosed) in the lifestyle group was reduced by 34 percent compared with placebo. For the group taking the diabetes drug metformin, diabetes incidence was reduced by 18 percent. Expressed another way, the lifestyle group delayed type 2 diabetes by about four years compared with placebo, and the metformin group delayed it by two years.
"The fact that we've continued to delay and possibly even prevent diabetes in people at very high risk for developing the disease is certainly a positive finding," says Dr. Crandall. She notes that those people randomly assigned to make lifestyle changes also had more favorable cardiovascular risk factors (including lower blood pressure and triglyceride levels) despite a reduction in drug treatment prescribed by their personal physicians.
The benefits of intensive lifestyle changes were especially pronounced among older people. Those aged 60 and over lowered their rate of developing type 2 diabetes in the next 10 years by about half.
The increase in the number of overweight Americans has led to an epidemic of type 2 diabetes that shows no signs of slowing. More than two-thirds of adults are now overweight or obese. About 11 percent of adults ─ 24 million people ─ have 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 major cause of kidney failure, limb amputations and new-onset blindness.
The researchers are now analyzing the DPPOS data to see whether clinical outcomes differ among the three groups. "The long-term weight loss and reduction in diabetes that we observed in DPPOS are encouraging," says Dr. Crandall. "But ultimately, establishing the benefits of preventing diabetes
|Contact: Deirdre Branley|
Albert Einstein College of Medicine