Lifestyle Changes Beat Medication in Preventing Type II Diabetes

BALTIMORE--Researchers from Johns Hopkins University found that both dietary intervention and medication prevented or delayed the onset of Type II diabetes in adults at risk of developing the disease. In fact, the lifestyle intervention, including losing weight and exercising, was more effective than medication.

The study was conducted by the Diabetes Prevention Program Research Group (DPP) and published in the Feb. 7, 2002, issue of The New England Journal of Medicine (345:393-403) (http://content.nejm.org). Nondiabetic persons were randomly assigned to placebo, metformin (850 mg twice daily) or a lifestyle-modification program with the goals of at least 7-percent weight loss and 150 minutes of physical activity per week. After an average follow up of almost three years, lifestyle intervention reduced the incidence of Type II diabetes by 58 percent, while metformin lowered the cases by 31 percent.

"[The DPP trial] conclusively proves that Type II diabetes is not inevitable for people at high risk of developing it," said Christopher Saudek, M.D., president of the American Diabetes Association (ADA) and a principal investigator of the DPP study site. "We now have the proof we need to begin to stem the tide of the Type II diabetes epidemic in America." Type II diabetes affects approximately 8 percent of U.S. adults, with an additional 10 million Americans considered at risk.

The ADA convened an advisory group of diabetes experts from such organizations as the Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases to develop a paper on the implications of the DPP report. It expects to publish the paper as an official Position Statement of the ADA in the April issue of Diabetes Care.