  
Lifestyle intervention program prevents type 2 diabetes in high-risk patients
Last Updated: 2001-05-02 17:00:34 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) - An outpatient intervention program designed to effect changes in lifestyle significantly reduced the incidence of type 2 diabetes in patients with impaired glucose tolerance, Finnish investigators report.
Dr. Jaakko Tuomilehto of the National Public Health Institute in Helsinki and associates devised an intervention with goals of reducing weight by at least 5% and total fat intake to less than 30% of energy consumed. As described in The New England Journal of Medicine for May 3, goals also included an increase in fiber intake to at least 15 g per 1000 kcal, and moderate exercise for at least 30 minutes per day.
The investigators randomly assigned 265 subjects to the intervention and 257 subjects to a control group. Those receiving the intervention met with a nutritionist seven times during the first year and every 3 months thereafter. They also received individual guidance on increasing physical activity. Control subjects were given information about diet and exercise at baseline and then annually.
Those in the intervention group lost a mean of 4.2 kg during the first year, compared with 0.8 kg in the control group, with the difference in weight loss remaining significant after 2 years. Fasting plasma glucose concentration declined by a mean of 2 mg/dL in the intervention group over 2 years, and increased by 3 mg/dL in the control group.
At the end of 2 years, 27 intervention group subjects and 59 control group subjects were diagnosed with diabetes, translating to an absolute incidence of 32 and 78 cases per 1000 person-years, respectively.
"It is commonly argued that it is difficult to change the lifestyle of obese and sedentary people," writes Dr. Tuomilehto's group, "but such pessimism may not be justified." They suggest that individuals with impaired glucose tolerance will participate in an intervention program "if it is made available to them."
In an editorial, Dr. P. Antonio Tataranni and Dr. Clifton Bogardus comment that these findings were "not a foregone conclusion." The physicians, both of the National Institutes of Health in Phoenix, question whether the reduced incidence of diabetes will last, and if a similar intervention would be as successful in other populations.
If these findings are confirmed, Drs. Tataranni and Bogardus write, "Physicians and policymakers may wish to consider whether such intervention programs should be routinely covered by insurance companies and made more broadly available in primary care settings."
N Engl J Med 2001;344:1343-1350,1390-1391.
-Westport Newsroom 203 319 2700
|
Copyright 2001 Reuters Limited. All rights reserved. Republication or redistribution of Reuters Limited content, including by framing or similar means, is expressly prohibited without prior written consent of Reuters Limited. Reuters Limited shall not be liable for any error or delays in the content, or for any actions taken in reliance thereon.
|
|
 Back To Fertility Wellness Center
| 
