Now, keep up to date
with daily feeds of newly posted stories
about America's Seniors...click on the box
to the left
Lifestyle changes may stave off Diabetes for
a Decade
Newswise — 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 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.
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,” says Dr. Crandall. 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.
About Albert Einstein College of
Medicine of Yeshiva University
Albert Einstein College of Medicine of
Yeshiva University is one of the nation’s
premier centers for research, medical
education and clinical investigation.
It is home to 2,775 faculty members, 625 M.D. students, 225
Ph.D. students, 125 students in the combined
M.D./Ph.D. program, and 380 postdoctoral
research fellows. In 2008, Einstein received
more than $130 million in support from the
NIH. This includes the funding of major
research centers at Einstein in diabetes,
cancer, liver disease, and AIDS.
Other areas where the College of Medicine is concentrating
its efforts include developmental brain
research, neuroscience, cardiac disease, and
initiatives to reduce and eliminate ethnic
and racial health disparities.
Through its extensive affiliation network involving eight
hospitals and medical centers in the Bronx,
Manhattan and Long Island – which includes
Montefiore Medical Center,
The University Hospital and Academic Medical Center for
Einstein – the College of Medicine runs one
of the largest post-graduate medical
training programs in the United States,
offering approximately 150 residency
programs to more than 2,500 physicians in
training. For more information, please visit
www.einstein.yu.edu
... ..
...
...