Results from the 20-year Diabetes Prevention Program.
Diabetes is currently one of the top 10 causes of mortality among African-Americans and Latin Americans.
Some of the complications associated with diabetes are problems with veins and blood circulation requiring amputation, cardiovascular disease, eye problems and kidney disease.
In 2002, the New England Journal of Medicine published a study that showed that lifestyle intervention with dietitians was more effective than metformin (drug) and placebo in preventing diabetes.
All 3,234 participants in the study had borderline diabetes. Participants were divided into three groups: The lifestyle intervention group, the pharmacological group or the placebo group.
The lifestyle intervention group received 45-60 min sessions with a dietitian approximately once per week over a period of 16 to 24 weeks. Interventions were personalized and tailored to meet the needs of the participants. After the first 16 sessions, participants had face-to-face sessions with a dietitian every two months, with at least one telehealth consultation in between.
The pharmacological group received general lifestyle guidelines and metformin, which was taken as prescribed.
The placebo group likewise received general lifestyle guidelines, but no treatment.
After 5 years there was a 58% decrease in the incidence of diabetes in the lifestyle intervention group. In addition there was a significant reduction in the risk factors for cardiovascular disease.
The lifestyle intervention group had significantly lower weight, lower blood pressure, lower cholesterol, and lower triglycerides. These findings are very encouraging as cardiovascular disease is the leading cause of death among patients with Type 2 diabetes.
In the pharmacological group, metformin treatment resulted in a 31% decrease in the incidence of diabetes. However, in this group there was also a significantly higher rate of adverse gastrointestinal symptoms reported.
In 2015, a follow-up study was published in the Lancet Diabetes Endocrinology journal. The follow-up analysis of the Diabetes Prevention Program allowed researchers to conclude that the benefits of lifestyle intervention persist for at least 15 years.
Clearly, Type 2 diabetes can be prevented or delayed with nutrition and lifestyle intervention. Despite this, diabetes is increasing globally.
According to stats Canada, diabetes has risen steadily within the Canadian population over the past 15 years. In 2015 approximately 7% of Canadians had diabetes compared to approximately 4% in the year 2000. Even more alarming is the estimated prevalence of pre-diabetes (borderline diabetes) in the population. According to diabetes Canada, an estimated 22% of Canadians over the age of 20 currently have borderline diabetes. This means that about 30% of the Canadian population is either diabetic or borderline diabetic. In other words, almost 1 in 3 people in the population are at risk of developing the previously mentioned complications associated with diabetes.
Although the population statics are cause for serious concern, the clinical research shows that people can indeed avoid becoming victims to diabetes.
Lifestyle intervention is key; however, if you are a medicated diabetic be sure to discuss with your physician which aspects of lifestyle intervention are appropriate for you.
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