Lifestyle Changes Can Work Better Than A Drug In Delaying Diabetes

English: Overview of the most significant possible symptoms of diabetes. See Wikipedia:Diabetes#Signs_and_symptoms for references. Model: Mikael Häggström. To discuss image, please see Template talk:Häggström diagrams (Photo credit: Wikipedia)

In the late 1990s, the Diabetes Prevention Program randomly assigned, to one of three groups, roughly 3,200 people who were at risk for diabetes because they were overweight or obese and had fasting blood sugar levels that were elevated (at least 95 mg/dL) but not high enough to warrant a diagnosis of diabetes (126 mg/dL or higher).

Those assigned to the intensive lifestyle group were encouraged to lose at least 7 percent of their body weight and to exercise for at least 2½ hours a week. The drug group was given the oral diabetes drug metformin (850 milligrams twice a day), and the placebo group was given lookalike but inactive pills.

In 2001, the researchers halted the study one year earlier than planned because the results were so clear: The risk of diabetes was 58 percent lower in the intensive lifestyle group than in the placebo group. Metformin cut the risk by 31 percent versus the placebo.

In a follow-up study, the researchers invited the people from all three of the original groups to attend coaching sessions on intensive lifestyle changes every three months. During the next six years, the people from the original intensive lifestyle group maintained their lower risk of diabetes, while the risk of people from the original drug and placebo groups declined.

But since the people in the original lifestyle group had a head start, their 10-year risk of diabetes was 34 percent lower than the risk of those in the original placebo group. The metformin group’s risk was 18 percent lower than the original placebo group’s.

What to do: How much proof do you need? Lose that excess weight and get moving.

Source: Lancet 374: 1677, 2009.