Diabetes Onset Delayed By Lifestyle Changes

A healthy lifestyle, with or without medications that promote weight loss or insulin sensitization, could delay the onset of type 2 diabetes among individuals with prediabetes, according to the findings of a recent meta-analysis.

For their meta-analysis, the researchers identified 43 randomized clinical trials that included 49,029 participants at risk for diabetes using Medline, Embase, Cochrane Library, and Web of Science databases. Nineteen of the studies assessed the effects of lifestyle modifications, 19 assessed the effects of medications, and 5 assessed the effects of combined medication and lifestyle interventions on the risk of developing diabetes.
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The researchers compared the relative risk (RR) of developing diabetes in the control and invention groups and stratified the results by treatment subtype. In addition, the researchers estimated the sustainability of each intervention by assessing RR during post-washout or follow-up periods.

Overall, lifestyle modifications were associated with a RR reduction of 39% and medications were associated with an RR of 36% at the end of the active intervention periods. The observed risk difference for the lifestyle modification and medication studies was 4 cases per 100 person-years, with a number needed-to-treat of 25.

After a mean 7.2 years of follow-up, lifestyle modifications had a RR reduction of 28% but medication interventions showed no sustained RR reduction.

“In adults at risk for diabetes, [lifestyle modification] and medications (weight loss and insulin-sensitizing agents) successfully reduced diabetes incidence. Medication effects were short lived,” the researchers concluded. “The [lifestyle modification] interventions were sustained for several years; however, their effects declined with time, suggesting that interventions to preserve effects are needed.”

—Melissa Weiss

Reference:

Haw JS, Galaviz KI, Straus AN, et al. Long-term sustainability of diabetes prevention approaches: a systematic review and meta-analysis of randomized clinical trials [published online November 6, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.6040.