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- diabetes
- Overview
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Diabetes prevention through diet and exercise
In 1996, NIDDK launched its Diabetes Prevention Program (DPP). The goal of this research effort was to learn how to prevent or delay type 2 diabetes in people with impaired glucose tolerance (IGT), a strong risk factor for type 2 diabetes.
The findings of the DPP, which were released in August 2001, showed that people at high risk for type 2 diabetes could sharply lower their chances of developing the disease through diet and exercise. In addition, treatment with the oral diabetes drug metformin also reduced diabetes risk, though less dramatically. These results were so striking that the DPP's external data monitoring board advised ending the trial early.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5 to 7 percent of their body weight. Participants randomized to treatment with metformin reduced their risk of getting type 2 diabetes by 31 percent.
Of the 3,234 participants enrolled in the DPP, 45 percent were from minority groups that suffer disproportionately from type 2 diabetes: African Americans, Hispanic Americans, Asian Americans and Pacific Islanders, and American Indians. The trial also recruited other groups known to be at higher risk for type 2 diabetes, including individuals age 60 and older, women with a history of gestational diabetes, and people with a first-degree relative with type 2 diabetes. Participants ranged from age 25 to 85, with an average age of 51.
Lifestyle intervention successfully reduced the risk of getting type 2 diabetes for both men and women, and across all the ethnic groups. It reduced the development of diabetes in people ages 60 and older by 71 percent. Metformin was also effective in men and women and in all the ethnic groups, but was relatively ineffective in the older volunteers and in those who were less overweight.
Researchers will continue to analyze the data to determine whether the interventions reduced cardiovascular disease and atherosclerosis, major causes of death in people with type 2 diabetes. The DPP is the first major trial to show that diet and exercise can effectively delay diabetes in a diverse American population of overweight people with IGT.
Points to Remember
- In 2000, about 2 million Hispanic Americans were known to have diabetes.
- 10.2 percent of all Hispanic Americans have diabetes.
- Being overweight or physically inactive is a major risk factor for developing diabetes. Hispanic Americans have high rates of both of these risk factors.
- Healthy lifestyles, such as eating healthy foods and getting regular exercise, are particularly important for people who are at increased risk of diabetes. Some diabetes may be prevented with weight control and regular physical activity.
- Hispanic Americans with diabetes have a higher incidence of diabetes complications such as eye and kidney disease than non-Hispanic whites. However, they may have lower rates of heart disease.
- If Hispanic Americans can prevent or control their diabetes, their risk of complications will decrease.
Source: DIABETES from the National Diabetes Clearinghouse.