Diet, Exercise Interventions Over 6 Years May Prevent or Delay Diabetes for 14 Years

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Title: Diet, Exercise Interventions Over 6 Years May Prevent or Delay Diabetes for 14 Years
URL: http://www.pslgroup.com/dg/221D12.htm
Doctor's Guide
May 22, 2008

NEW YORK -- May 22, 2008 -- Group-based diet and exercise lifestyle interventions over 6 years may prevent or delay diabetes for up to 14 years after the intervention period, conclude study results from the May 1 issue of The Lancet. But whether lifestyle interventions also lead to reduced cardiovascular disease (CVD) and mortality remains unclear.

Professor Guangwei Li, China-Japan Friendship Hospital, Beijing, China, and Ping Zhang, PhD, US Centers for Disease Control and Prevention, Atlanta, Georgia, and colleagues performed the China Da Qing Diabetes Prevention Outcome Study (CDQDPOS), which followed patients after 20 years postenrolment.

In 1986, researchers randomly assigned 577 adults with impaired glucose tolerance from 33 clinics in China to the control group or to 1 of 3 lifestyle intervention groups (diet, exercise, or diet plus exercise). Active intervention took place over 6 years until 1992, and in 2006, study participants were followed up to assess the long-term effect of the interventions. Primary outcomes were diabetes incidence, CVD incidence and mortality, and all-cause mortality.

Compared with control participants, the combined lifestyle interventions reduced the incidence of diabetes by nearly one-half (51%) during the active intervention period and by 43% over the whole 20-year period.

The average annual incidence of newly diagnosed diabetes was 7% for intervention participants and 11% in control participants. At the end of the 20 years, 80% of the intervention group had diabetes compared with 93% of the control group. Those in the intervention group spent an average of 3 to 6 fewer years with diabetes than those in the control group.

Although there was no significant difference between intervention and control groups in the rate of first CVD events, CVD mortality, and all-cause mortality, the study had limited statistical power to detect differences for these outcomes.

"This study has shown that, in Chinese people with impaired glucose tolerance, group-based interventions targeting lifestyle changes such as diet and exercise produce a durable and long-lasting reduction in incidence of type 2 diabetes," concluded the authors. "Since around 3 million excess deaths a year are attributable to diabetes worldwide, lifestyle interventions seem to be a justifiable public-health action both in developed and developing nations."

SOURCE: The Lancet

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