July 17, 2013
Pre-Diabetics May Ward Off Type 2 Diabetes If They Lose That Weight
Brett Smith for redOrbit.com - Your Universe Online
Individuals that are considered pre-diabetic, by having elevated blood glucose levels, still have a chance to avoid full-blown type 2 diabetes if they can shed 10 percent of their body weight, according to a new study in Journal of General Internal Medicine.
"We have known for some time that the greater the weight loss, the lower your risk of diabetes," said lead author Dr. Nisa Maruthur, an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "Now we understand that we can see much of the benefit of losing that weight in those first six months when people are adjusting to a new way to eating and exercising.
"Substantial weight loss in the short term clearly should go a long way toward preventing diabetes," Maruther added.
The study is based on analyzing data from the Diabetes Prevention Program (DPP), the biggest diabetes prevention study in the United States. The DPP recruited 3,000 overweight, hyperglycemic individuals from 1996 to 1999. Volunteers were followed for 3.2 years and were randomly assigned to receive a lifestyle intervention, the diabetes drug metformin, or a placebo.
The lifestyle intervention group were educated on eating habits, told to exercise 150 minutes a week, and given both individual and group counseling services. Participants in this group who lost 10 percent or more of their body weight showed an 85 percent lower risk for developing diabetes within three years. Those in the lifestyle group who lost 5 to 7 percent of their body weight showed a 54 percent lower risk, researchers said.
Participants who were given the diabetes drug metformin did not tend to lose significant amounts of weight. However, the drug was shown to lower blood sugar levels in many individuals, which correlated to lower risk of developing diabetes, according to the report.
Maruther noted that patients who lost weight and lowered their blood glucose levels showed the lowest risk for developing full blown diabetes.
"I'm usually thrilled if a patient loses 3 to 5 percent of his or her body weight after six months, but based on this new knowledge, if patients aren't losing more weight and if their glucose remains elevated, it might be time to escalate treatment by prescribing metformin," she said.
The Johns Hopkins doctor said very few of her colleagues prescribe metformin to individuals who are considered pre-diabetic, yet the study shows they might benefit. She added the current system isn't enough to stave off full blown diabetes in many cases.
"Right now, the doctor and patient discuss this and may not discuss it again until the next appointment, which may be six months away or even longer," Maruther said. "This routine isn't getting us anywhere."
Since insurance plans don't cover the type of lifestyle intervention routine used by the DPP, many patients don't have access to them.