People with prediabetes dramatically reduce their risk of developing type 2 diabetes over the next three years if they lose roughly 10% of their body weight within six months of diagnosis, according to a study.
The research suggests that if people with prediabetes do not lose enough weight in those first months, physicians may want to consider more aggressive treatment, such as adding a medication to push blood sugar levels lower.
Nisa Maruthur, MD, MHS, the studys lead author and an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine, and colleagues based their conclusions on analysis of data from the Diabetes Prevention Program, described as the largest diabetes prevention study in the United States. Overweight, hyperglycemic people were recruited between 1996 and 1999 and followed for an average of 3.2 years.
More than 3,000 participants at 27 academic medical centers were assigned at random to receive either an intense lifestyle intervention, doses of metformin to reduce blood glucose levels or a placebo.
Participants in the lifestyle arm of the DPP were advised about better eating habits, directed to exercise 150 minutes a week and given one-on-one counseling for the first six months and group counseling thereafter. As published July 16 on the website of the Journal of General Internal Medicine, the researchers found that those in the lifestyle intervention arm who lost 10% or more of their body weight had an 85% reduction in risk of developing diabetes within three years.
More moderate weight loss showed positive effects as well, the researchers reported. Those who lost 5% to 7% of their body weight reduced their risk of developing diabetes by 54% three years later.
Those who were given metformin did not lose significant amounts of weight on average. But those whose blood sugar levels were significantly lowered in six months likewise had a lesser risk of developing diabetes.
The lowest risk, Maruthur said in a news release, occurred in patients who lost weight and also lowered the amount of glucose in their blood, as measured by a blood test taken after fasting. “Im usually thrilled if a patient loses 3% to 5% of his or her body weight after six months, but based on this new knowledge, if patients arent losing more weight and if their glucose remains elevated, it might be time to escalate treatment by prescribing metformin.”
Study abstract: http://link.springer.com/article/10.1007/s11606-013-2548-4.