Diabetes Prevention Program
Type 2 Diabetes and Prediabetes continued...
About 23.6 million people in the U.S. have diabetes. Ninety-percent to 95% of people with diabetes have type 2 diabetes. This is a lifestyle disease and can be prevented. Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness in American adults. People with diabetes are also two to four times more likely than people without diabetes to develop heart disease.
Prediabetes, also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), is a condition in which your blood sugar levels are higher than normal but not high enough for a diagnosis of diabetes. Having prediabetes puts you at higher risk for developing type 2 diabetes. If you have prediabetes, you are also at increased risk for developing heart disease.
You are more likely to develop type 2 diabetes if:
- You are overweight
- You are 45 years old or older
- You have a parent, brother, or sister with diabetes
- Your family background is African-American, American Indian, Asian American, Hispanic American/Latino, or Pacific Islander
- You have had gestational diabetes or gave birth to at least one baby weighing more than 9 pounds
- Your blood pressure is 140/90 or higher, or you have been told that you have high blood pressure
- Your HDL -- or "good" -- cholesterol is 35 or lower, or your triglyceride level is 250 or higher
- You are fairly inactive, or you exercise fewer than three times a week
It's estimated that 57 million American adults older than age 20 have IFG, suggesting that at least 57 million adults have prediabetes. Those with prediabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes. The results of the Diabetes Prevention Program showed that modest weight loss and regular exercise could prevent or delay type 2 diabetes.
The DPP's striking results tell us that millions people at risk for type 2 diabetes can use diet, exercise, and behavior modification to avoid the disease. The DPP also suggests that metformin is effective in delaying the onset of diabetes.
Participants in the lifestyle intervention group -- those receiving intensive counseling on effective diet, exercise, and behavior modification -- reduced their risk of developing diabetes by 58%. This finding was true across all participating ethnic groups and for both men and women. Lifestyle changes worked particularly well for participants aged 60 and older, reducing their risk by 71%. About 5% of the lifestyle intervention group developed diabetes each year during the study period, compared with 11% in those who did not get the intervention. Researchers say that weight loss -- achieved through better eating habits and exercise -- reduces the risk of diabetes by improving the ability of the body to use insulin and process glucose.
Participants taking metformin reduced their risk of developing diabetes by 31%. Metformin was effective for both men and women, but it was least effective in people aged 45 and older. Metformin was most effective in people aged 25 to 44 years old and in those with a body mass index of 35 or higher (at least 60 pounds overweight). About 7.8% of the metformin group developed diabetes each year during the study, compared with 11% of the group receiving the placebo.