Diet, Exercise and Metformin Help Prevent Diabetes

 Today is American Diabetes Association Alert Day, and in recognition today’s posts will be covering topics in diabetes.

Diabetes Mellitus Type II (DM2) is common in the U.S. and worldwide and it’s incidence and prevalence are increasing. The implications of DM2 are serious and widespread, including kidney and eye disease, heart and blood vessel disease, and neuropathies.

Because of the large numbers of people with DM2, there has been much research looking at ways to prevent or forestall its development. A landmark study in this area was published in 2002, and was conducted at George Washington University and 27 affiliated centers.

Over three thousand participants with elevated fasting and post-load plasma glucose concentrations were included in the study. Subjects were randomly assigned to a lifestyle modification plus metformin group (850 mg twice a day), a lifestyle modification plus placebo group, or a program of intense lifestyle modifications. The goals for the intensive lifestyle modification group were to maintain a 7% weight reduction and engage in moderate physical activity for at least 150 minutes each week. The average follow-up period was 2.8 years.

The primary outcome measure of this preventative study was the development of diabetes. The incidence of diabetes was 58% lower in the intensive lifestyle intervention group compared to the placebo group, while the incidence of diabetes in the metformin group was 31% lower than the placebo group.

Comparing the intensive lifestyle-modification group to the metformin group shows the incidence of diabetes was 39% lower in the intensive lifestyle modification group.

One of the important features of the study design were that substantial numbers of female subjects were enrolled (68% female, 32% male), and that a large percentage of African-American, Hispanic, Indian American and Asian-American individuals were enrolled, which supports the generalizeability of these results to a broad heterogeneous population such as seen in the U.S.

This study demonstrates that substantial lifestyle modifications including weight loss and increased exercise may have a profound impact in preventing or delaying the development of DM2 in those at risk. Given the serious health implications of DM2 perhaps those who are in the pre-diabetic stage may want to consider incorporating improved diet, exercise and weight loss in to their daily regimen.

 

(Source- New England Journal of Medicine, Vol. 346, No. 6)

This blog is a review of medical and scientific literature, and should only be used for informational purposes. It does not constitute medical or health advice, nor does it create a physician-patient relationship with anyone. Discuss any health concerns with your personal physician.