Practical Practitioner
By: Pamela Egan, FNP-C CDE
Type 2 Diabetes Prevention
For high-risk individuals, lifestyle changes are the first line of defense when it comes to diabetes prevention. New results of the Finnish Diabetes Prevention Study indicate that even in patients who are at a high risk for type 2 Diabetes, increased physical activity is associated with a significant reduction in the risk of developing the disease.
The study was conducted in Finland and examined 522 patients who were at high risk of developing type 2 Diabetes.
At baseline, all participants were aged 40 to 65, were overweight or obese, and had impaired glucose tolerance.
The 522 patients were divided into two groups, an intervention group and a control group.
The intervention group was given detailed advice regarding exercise and lifestyle changes to aide in type 2 diabetes prevention, including recommendations to get at least 30 minutes of moderate to vigorous exercise per day and to reduce their intake of carbohydrates.
They were encouraged to participate in leisure-time physical activities, such as swimming, jogging, biking and skiing.
A free, supervised circuit-type resistance training program was also offered.
The control group was given general information on exercise and diet at baseline but received no specific guidelines or advice regarding physical activity.
Patients in both groups were followed for 4.1 years. The results showed that even a total of 2.5 hours of brisk walking each week can reduce the risk of developing type 2 diabetes by as much as 50 percent.
This is much more than could be achieved by current anti-diabetic drugs. Physical activity is recommended for all patients who are at a high risk for type 2 diabetes.
In high-risk persons, such as those with central obesity, a family history of type 2 diabetes and those with metabolic syndrome, lifestyle changes are the first line of treatment in the prevention of diabetes.
These recommendations do work, they are well-documented, and they are rational in terms of what we know about the basis of this disease.
Evidence is accumulating that even relatively modest ‘lifestyle changes’ can prevent or slow the progression to type 2 Diabetes in patients at high risk for this disease.
These studies have typically changed many lifestyle aspects including diet, physical activity and weight loss.
This study’s analysis confirms that not only strenuous exercise but also moderate and lower intensity activities conferred benefits.
Furthermore, increased physical activity, even without significant weight loss, appeared to afford important advantages.
This is good news for patients at risk for diabetes and metabolic syndrome since so often they become quickly discouraged after increasing physical activity without losing the weight they expected.
The Centers for Disease Control and Prevention and American College of Sports Medicine guidelines recommend that individuals engage in 30 minutes or more of moderate intensity physical activity on most but preferably all days of the week. This remains an appropriate benchmark for lifestyle counseling.
This article was originally published April 11, 2005 in The St. Tammany News.
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