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Diet and exercise prevent diabetes |
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Clinical Question: Do diet and exercise delay the development of diabetes in high-risk patients? Bottom Line: Lifestyle intervention (Diet and exercise) in people at high risk for type 2 diabetes resulted in sustained lifestyle changes and a reduction in diabetes incidence. Reference: Lindstrom J, Ilanne-Parikka P, Peltonen M, et al, for the Finnish Diabetes Prevention Study Group. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 2006;368:1673-1679. Study Design: Randomized controlled trial (nonblinded) Funding: Synopsis: In the Finnish Diabetes Prevention Study, 522 men and women, aged between 40 years and 65 years and at high risk for developing diabetes, were randomly assigned either to a tailored diet-and-exercise regimen or to usual care. To be eligible subject must be overweight, middle-aged with impaired glucose tolerance. They were randomly assigned to intensive lifestyle intervention or control group. After a median of 4 years of active intervention period, participants who were still free of diabetes were further followed up for a median of 3 years, with median total follow-up of 7 years. Diabetes incidence, bodyweight, physical activity, and dietary intakes of fat, saturated fat, and fibre were measured. During the total follow-up, the incidence of type 2 diabetes was 4.3 and 7.4 per 100 person-years in the intervention and control group, respectively (log-rank test p=0.0001), indicating 43% reduction in relative risk. The risk reduction was related to the success in achieving the intervention goals of weight loss, reduced intake of total and saturated fat and increased intake of dietary fibre, and increased physical activity. Beneficial lifestyle changes achieved by participants in the intervention group were maintained after the discontinuation of the intervention, and the corresponding incidence rates during the post-intervention follow-up were 4.6 and 7.2 (p=0.0401), indicating 36% reduction in relative risk. |
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