Seniors May Reduce Risk of Type 2 Diabetes by Half
with More Exercise, Less Weight
Modest weight loss or taking anti-diabetic drug for
10 years lowers risk of type 2 diabetes in high risk people of all
ages
Nov. 2, 2009 – Seniors aged 60 or older –
among the most
likely to develop type 2 diabetes – can cut their risk of developing the
disease over the next ten years in half with intensive lifestyle changes
that include increased physical activity and sustained weight loss.
Sustaining modest weight loss for 10 years, or
taking an anti-diabetic drug over that time, can prevent or lower the
incidence of type 2 diabetes in people of all ages at high risk for
developing the disease, according to the Diabetes Prevention Program
Outcomes Study (DPPOS), a long-term follow-up to a landmark 2001
diabetes prevention study.
Study of seniors finds physical activity, good
dietary habits, not smoking and light alcohol use lowers diabetes risk
by 82%; four in five new cases attributable to not having these low-risk
factors.
Jill Crandall, M.D.Jill Crandall, M.D., associate
professor of clinical medicine at Albert Einstein College of Medicine of
Yeshiva University, was a principal investigator in the follow-up study,
which appears online in the current edition of the British medical
journal The Lancet.
The original study - the Diabetes Prevention
Program (DPP) - was a large, randomized trial involving 3,234 people at
high risk for developing diabetes.
At the start of the study, all were overweight or
obese adults with elevated blood glucose levels. Researchers disclosed
the findings from DPP in 2001 - a year earlier than scheduled - because
results were so clear.
After three years, intensive lifestyle changes
(modest weight loss coupled with increased physical activity) reduced
the rate for developing type 2 diabetes by 58 percent compared with
placebo.
The oral diabetes drug metformin (850 milligrams
twice daily) reduced the rate of developing diabetes by 31 percent
compared with placebo.
Since these striking results were based on just
three years of data, researchers could not determine how long the
benefits would last.
Following a seven-month bridge period after the
original study ended, the follow-up DPPOS began, with 88 percent of DPP
volunteers taking part.
During the study pause, all participants learned
the results and were offered 16 education sessions on making intensive
lifestyle changes.
The latest results, reflecting a full decade of
participation - three in the DPP study and seven in DPPOS - indicate
that lifestyle interventions producing even modest weight loss can
significantly help to prevent or delay diabetes over the long term.
Specifically, for the 10 years spanning the DPP and
DPPOS studies, the diabetes incidence (i.e., rate at which new diabetes
cases were diagnosed) in the lifestyle group was reduced by 34 percent
compared with placebo.
For the group taking the diabetes drug metformin,
diabetes incidence was reduced by 18 percent. Expressed another way, the
lifestyle group delayed type 2 diabetes by about four years compared
with placebo, and the metformin group delayed it by two years.
"The fact that we've continued to delay and
possibly even prevent diabetes in people at very high risk for
developing the disease is certainly a positive finding," according to
Jill Crandall, M.D.
"The fact that we've continued to delay and
possibly even prevent diabetes in people at very high risk for
developing the disease is certainly a positive finding."
She notes that those people randomly assigned to
make lifestyle changes also had more favorable cardiovascular risk
factors (including lower blood pressure and triglyceride levels) despite
a reduction in drug treatment prescribed by their personal physicians.
The benefits of intensive lifestyle changes were
especially pronounced among older people. Those aged 60 and over lowered
their rate of developing type 2 diabetes in the next 10 years by about
half.
The increase in the number of overweight Americans
has led to an epidemic of type 2 diabetes that shows no signs of
slowing. More than two-thirds of adults are now overweight or obese.
About 11 percent of adults - 24 million people -
have diabetes, and up to 95 percent of them have type 2 diabetes,
according to the National Institutes of Health. Diabetes is a major
cause of heart disease and stroke and the major cause of kidney failure,
limb amputations and new-onset blindness.
The researchers are now analyzing the DPPOS data to
see whether clinical outcomes differ among the three groups.
"The long-term weight loss and reduction in
diabetes that we observed in DPPOS are encouraging," says Dr. Crandall.
"But ultimately, establishing the benefits of preventing diabetes means
showing that you can reduce the deaths and the severe complications
associated with this disease."
The study, "10-year Follow-up of Diabetes Incidence
and Weight Loss in the Diabetes Prevention Program Outcomes Study,"
appears in the October 29, 2009 online edition of The Lancet.
In addition to Dr. Crandall, other Einstein
researchers involved in DPPOS were Harry Shamoon, M.D., Elizabeth
Walker, Ph.D., Judith Wylie-Rosett, Ed. D., Swapnil Rajpathak, M.B.B.S,
Dr. P.H., and Janet Brown-Friday, R.N., M.P.H.
Keep up with the latest news for senior citizens, baby
boomers
Nov. 2, 2009 – Seniors aged 60 or older –
among the most
likely to develop type 2 diabetes – can cut their risk of developing the
disease over the next ten years in half with intensive lifestyle changes
that include increased physical activity and sustained weight loss.
The oral diabetes drug metformin (850 milligrams
twice daily) reduced the rate of developing diabetes by 31 percent
compared with placebo.