Long-Term Lifestyle Changes Result in 34 Percent Lower Risk of Developing Diabetes in High Risk Patients
An ongoing research study has found that patients who adopted a healthier lifestyle have a 34 percent lower risk of developing diabetes. Those patients who embraced the lifestyle changes also experienced drops in heart disease risk factors including blood pressure, cholesterol and triglycerides. The study, sponsored by the National Institutes of Health, Centers for Disease Control and Prevention, Indian Health Service, and the American Diabetes Association, was conducted in 27 centers nationwide and included over 3,800 patients who were at a high risk of acquiring the disease. The Diabetes Prevention Program Outcomes Study (DPPOS) is a continuation of the Diabetes Prevention Program (DPP) which began in 1996. DPPOS will continue through 2013. Jefferson trial site Principal Investigator Serge Jabbour, M.D., Interim Director, Division of Endocrinology, Diabetes & Metabolic Diseases Jefferson Medical College, Thomas Jefferson University and his co-authors report their findings in the October 29th online edition of the The Lancet.
“Diabetes has become a problem of literally epidemic proportions here in the United States,” said Jabbour. “This study shows that people at high risk can delay the onset of this disease for years by embracing some moderate lifestyle changes. This delay can save both the patient and the healthcare industry millions of dollars in treatment and resources.”
Originally the DPP primary goal was to prevent or delay Type 2 diabetes in people with impaired glucose tolerance (IGT). People who have IGT are at elevated risk of developing diabetes. Those initial results found a 58 percent reduction in patients who adopted the lifestyle changes. Due to this success the DPP was continued under the DPPOS. 88 percent of the DPP patients continued being monitored under the DPPOS, which along with looking at delaying diabetes, also looked at complications of diabetes including kidney, eye, nerve and heart function.
“After 10 years of these combined studies our results point to weight loss being the key to delaying the onset of diabetes,” said Jabbour. “We lost some points percentage wise as the trial proceeded due to a number of external factors, including attrition, however, the numbers we do have after 10 years are outstanding. Plus we now have some positive data regarding diabetes complications that we are working on. We were excited to see that diabetes-related heart risks dropped in all our study participants.”
The randomized clinical trial assigned high risk patients to one of three groups. The first group changed their lifestyle, watching their diet and getting some moderate exercise. The second group was assigned a regiment of the drug Metformin, an oral diabetes drug that helps control blood sugar levels. This group was also a success. Patients in this group delayed the onset of diabetes by two years. The third group was used as a control group.
Diabetes frequency after 10 years was 52 percent for placebo, 47 percent for Metformin and 42 percent for lifestyle.
“After 10 years those 10 percentage points between the lifestyle group and the placebo group are pretty big and we believe the key was weight loss,” said Jabbour. “By reducing total calories and getting some exercise patients in the lifestyle group fared better than the other two groups. As we continue the study in the coming years we’re going to be looking at eye complications and doing both cognitive and physical function testing.”
The DPPOS will continue until December 2013.