Changes in exercise, diet and other behaviors can help people at high risk for type 2 diabetes avoid the disease, but such comprehensive modification programs may offer fewer benefits for those who already have diabetes, according to a study in the Annals of Internal Medicine.
About 90 percent of people with diabetes have type 2 diabetes, according to the National Diabetes Education Program. Being overweight is one of the major risk factors for the disease. Others include lack of physical activity, poor diet, high blood pressure and prediabetes, according to the American Diabetes Association (ADA).
Researchers analyzed the results of 20 previous studies in an effort to answer two basic questions: (1) Can multiple lifestyle changes help people at high risk for type 2 diabetes avoid the disease? (2) Can those changes help people who already have type 2 diabetes avoid cardiovascular disease and early death?
About the study
Researchers analyzed the findings from nine studies involving people at high risk for diabetes, as well as 11 studies involving people who already had the disease. Studies had to compare the effects of increased exercise, changes in diet and at least one other behavior modification to a lesser treatment—such as usual care, or diet or exercise alone.
Most studies found that people at high risk for type 2 diabetes who took part in lifestyle modification programs reduced their risk for developing the disease. And most studies found that the benefits lasted for as long as 10 years of follow-up.
In addition, high-risk people who made lifestyle changes lost significant amounts of weight—and kept it off for up to four years after the study ended. But only a handful of studies lasted that long and not all included details on weight change, so the authors urged caution on this finding.
However, there was limited evidence that a comprehensive program of lifestyle changes lowered the risk for premature death from any cause in people who already had type 2 diabetes. There was also insufficient evidence to conclude that multiple intensive behavior modifications were superior to changes in diet and exercise alone in reducing the risk for cardiovascular disease or vascular-related complications like eye, kidney or nerve problems.
|The take-home message|
|It’s important to keep in mind that this was a review of a relatively small number of studies, some of which the authors noted were flawed. And the evidence for individual studies’ findings was sometimes weak.There is growing evidence that, in people who have type 2 diabetes, tackling multiple risk factors simultaneously—versus one at a time—may help prevent complications, the authors wrote.
This study, however, was unable to conclude that a program of multiple lifestyle changes was better at preventing complications than changing diet and exercise alone.
Anyone at risk for type 2 diabetes or who already has the disease should talk with his or her doctor about how to maintain their health.
To learn more about the risk factors for type 2 diabetes, take this risk assessment.
Diabetes Prevention Program starting in December 2013
Memorial Diabetes Prevention and Wellness is offering an evidence based Diabetes Prevention Program, proven to help people lower their risk of type 2 diabetes. Participants will learn how to change their lifestyle and improve health in group meetings with a trained lifestyle coach. The program has 16 weekly one hour sessions and six monthly follow up sessions, and will be offered in both English and Spanish.
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