In the landmark diabetes prevention program, researchers found that a lifestyle intervention of exercise and diet was twice as effective as just taking the diabetes drug metformin, at preventing the progression from impaired glucose tolerance to type 2 diabetes over the subsequent 4 years. For some, the progression to diabetes was delayed by as much as a decade.

Since diabetes increases the risk of death from cardiovascular or any cause, it was assumed that a lifestyle intervention which prevents or delays diabetes would also prevent such a death, but unfortunately the diabetes prevention program missed out this analysis.

Now, the results of the Da Qing diabetes prevention study show that an initial lifestyle intervention in those with impaired glucose tolerance can still have beneficial effects two decades later.

The individuals in the Da Qing study changed their diet, physical activity, or both for 6 years only. 23 years later, compared to individuals who carried on with their lives as normal, those who made a positive change for 6 years were less likely to have diabetes, and were less likely to have died from cardiovascular disease or any cause.

This supports the previously missing evidence that lifestyle interventions such as exercise, to prevent or delay diabetes, also prevent the development of long term conditions such as cardiovascular disease which develop with diabetes and cause a huge economic burden to the NHS.

Faye Prior (Researcher)

Sources

Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393-403.

Diabetes Prevention Program Research Group. (2009). 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcome study. The Lancet, 374(9702), 1677-86.

Li, G., Zhang, P., Wang, J., An, Y., Gong, W. et al. (2014). Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study. The Lancet, Published ahead of print, doi:10.1016/S2213-8587(14)70057-9.

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