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    Can Diabetes Be Prevented?


    The treated group received individualized advice and support for making lifestyle changes -- including how to lower total and saturated fat, how to increase fiber in their diets, and how to get, and stay, more physically active. The participants had monthly consultations the first year and less frequent but regular visits in the following 4 years. The comparison group didn't receive such hands-on advice but did get tips about diet and exercise at their annual check-ups.

    But what if you're not so lucky as to get constant feedback and attention from a team of health care professionals? A British study presented at the ADA conference was designed with much less constant oversight and found that neither oral medication nor advice regarding a healthy lifestyle made much difference in preventing type 2 diabetes

    In this study, 188 participants at high risk for type 2 diabetes were randomly chosen to receive either reinforced lifestyle advice or basic advice on healthy living. At the same time, the participants were assigned to groups that either received the diabetes medication gliclazide daily, a placebo "dummy" pill, or no tablets at all.

    At the end of the six-year study, the participants receiving reinforced advice had lost somewhat more weight than the those getting basic advice, and they had less fat in their diets. However, the groups' rates of progression to diabetes were similar. The medication group, placebo group, and no-tablet group also had similar rates of progression.

    The difference between the studies is probably because the Finnish study involved more structure and support, while the British study focused on supportive advice, Holman tells WebMD.

    The problem with lifestyle changes is putting them into practice in a real-life situation, says Holman, professor of diabetic medicine at the University of Oxford in Cambridge, England. "The achievable ... changes in people leading routine lives are not large enough to reduce the risk of diabetes," he says. "Only greater changes will have this effect."

    Insulin injections may prevent type 1 diabetes in people at risk of developing it, says Tihamor Orban, MD. He and colleagues at the Joslin Diabetes Center in Boston have followed 31 participants who have a parent or a brother or sister with type 1 diabetes as well as the blood antibodies for diabetes. They shared their findings at the ongoing ADA conference.

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