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Men and women at high risk of developing type 2 diabetes can reduce this risk by losing weight and exercising, study findings show. The diabetes drug Glucophage can also cut diabetes risk if given preemptively, but not as dramatically.
About 8% of US adults have type 2 diabetes, in which the body loses the ability to respond properly to the blood sugar-regulating hormone insulin. There are well-known risk factors for the disease, including high blood sugar levels after fasting, being overweight, and living a sedentary lifestyle.
To determine whether targeting lifestyle factors with weight loss and exercise, or giving at-risk patients Glucophage, which helps the body respond better to insulin, would cut diabetes risk, the researchers compared these two approaches with an inactive placebo in more than 3,200 nondiabetic men and women.
The average age of study participants was 51, and all had high blood glucose levels. Their average body mass index (BMI) was 34. BMI is a measure of weight in relation to height, and a person with a BMI of 30 or higher is considered obese.
Study participants were randomly assigned to a placebo, 850 milligrams of Glucophage twice daily, or a lifestyle change program intended to help them lose at least 7% of their weight and engage in 150 minutes of physical activity per week.
During the follow-up period, which lasted nearly 3 years, the investigators found that patients in the lifestyle intervention group saw the greatest reduction in their diabetes risk. They had a 58% lower risk of developing type 2 diabetes than people in the placebo group. Those given Glucophage cut their diabetes risk by 31%.
The lifestyle program was significantly more effective than Glucophage therapy in all age groups.
This study shows that type 2 diabetes is not inevitable. It is not necessary to wait until a person has type 2 diabetes to begin doing something about it.
The New England Journal of Medicine February 7, 2002;346:393-403
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