Type 2 Diabetes Is Preventable
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Those in the comparison group were told that by changing dietary and exercise habits, they could reduce their risk of diabetes. They were given a two-page leaflet of nutritional suggestions, kept a three-day food diary at the beginning of the study and reported -- on each annual visit -- their nutrition habits.
The "intervention group" got considerably more attention: people were given detailed advice about how to achieve their goals -- how to reduce weight, total intake of fat, intake of saturated fat, increase in fiber. Each had seven sessions with a nutritionist during the first year and one session every three months afterwards. They were also coached to increase exercise to 30 minutes each day, mostly through "endurance exercise" such as walking, jogging, swimming, aerobic ball games or skiing.
On annual visits, if the doctor discovered that cholesterol level or blood pressure was high, the patient was advised to contact his or her doctor for treatment and follow-up.
At the study's end, researchers found that the incidence of diabetes was 58% lower in the intervention group than the comparison group. Among men the incidence was 63% lower; among women it was 54% lower. Those in the intervention group had made many more lifestyle changes than the others, and changes in weight, waist circumference, plasma glucose levels, serum insulin, serum lipids, and blood pressure were all significantly better in the intervention group.
The people in this study were counseled to do endurance exercises, to improve cardiorespiratory fitness and muscle strength. But merely becoming more active -- whether through "sports, household work, gardening, or work-related physical activity -- is similarly beneficial in preventing diabetes," Tuomilehto writes.
Even losing a small amount of weight made a difference, says Tuomilehto. "The effect of the intervention ... was most pronounced among subjects who made comprehensive changes in lifestyle." While the amount of weight lost was not large, those who lost at least 5% of their initial weight did not develop diabetes.
The message is clear, Sanders tells WebMD. "Being overweight -- and especially the presence of intra-abdominal fat -- is a very significant risk factor for development of type 2 diabetes. But lifestyle modification does make a difference ... individuals can benefit from weight loss, dietary modification, and exercise."