Practical Practitioner
By: Pamela Egan, FNP-C CDE
Type 2 Diabetes can be prevented
It’s official: The same things that help control Type 2 Diabetes also go a long way toward preventing it.
That’s the news from the Diabetes Prevention Program (DPP) sponsored by the National Institutes of Health. In August, the preliminary results showed that type 2 diabetes can be prevented. The DPP, a study of diabetes prevention in 3,234 overweight men and women aged 25 – 85 years with impaired glucose tolerance (IGT). Exercise, eating right and, for those who are overweight, losing about 15 pounds can slash the risk of developing diabetes as much as 71 percent in some people at high risk for the disease.
All participants in the study were considered to be at high risk for developing Type 2 Diabetes by virtue of having impaired glucose tolerance, a condition in which blood sugars are higher than normal but not high enough for a diagnosis of diabetes. All were overweight, with an average body mass index of 34. They ranged in age from 25 to 85 (average age: 51).
The DPP trial had several branches in the study, each with its own prevention strategy or intervention.
In the first group, the lifestyle group, participants received intensive guidance about nutrition and exercise. They attended individual or group counseling and education sessions about low-fat eating for six months, and they focused on keeping their caloric intake between 1,200 and 1,800 calories, with about 25 percent of those calories coming from fat. This group aimed to reduce their weight by 7 percent through a combination of healthy eating and getting 150 minutes of moderate exercise each week. Most preferred walking.
The second group took the drug metformin (Glucophage) twice a day. The third group, the control group, took dummy pills in place of metformin. The second and third groups received some information on diet and exercise, but much less than that provided to the first group.
Participants in the lifestyle group slashed their risk of developing diabetes 58 percent. For those age 60 or older their risk dropped 71 percent.
Risk decreased in the metformin group as well, although not as much. In this group, risk fell 31 percent. And the group that took the dummy pill? No risk reduction whatsoever. Each year 10 percent of the participants in this group developed Type 2 Diabetes.
You may ask “Is prevention permanent?” We simply don’t know how long beyond the three-year period studied that diabetes can be delayed. They hope to follow the participants to learn how long the interventions are effective.
Still, it’s a step in the right direction. This study proves that Type 2 Diabetes is not inevitable for people at high risk for developing it. We now have the proof we need to stop the tide of the Type 2 Diabetes epidemic in America. People at high risk for developing Type 2 Diabetes can take a good measure of hope for the future.
This article was originally published November 26, 2001 in The St. Tammany News.
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