Table 2: Conclusions of lifestyle intervention studies

 

Name of study

Other Relevant Findings

 

Da Qing [8]  

(20 yrs. follow up)

 

·         The reduction in diabetes incidence seen during the 6-year period of active intervention persisted for two decades.

·         Participants with impaired glucose tolerance randomised to lifestyle intervention groups had a 43% lower diabetes incidence for up to 14 years after the active intervention ceased, and diabetes onset was delayed an average of 3.6 years.

·         The risk of eventually developing diabetes in people with impaired glucose tolerance in the absence of intervention remains high for many years, since 93% of the controls developed diabetes over 20 years

 

IDDP [12]

 

·         The rate of progression in the Indian subjects was much higher that other populations in whom similar studies have been conducted. The rates in the Indian population were found to be 18.3%/year as opposed to 6%/year in the Finnish study.

·         Metformin in doses as low as 500mg/day effectively reduced the progression of IGT to Diabetes in Indian populations

·         In Indian Populations effectiveness of LSM and metformin were found to be similar whereas in all other populations LSM was found to be a superior intervention

 

US DPP [11,19]

 

·         50% of the participants in the lifestyle intervention group achieved the goal of weight loss of 7% or more by the end of the 24 weeks and 74% met the goal of at least 150 minutes of physical activity per week. The daily energy intake decreased by a mean of 249 ± 27 kcal in the placebo group, 296 ± 23 kcal in the metformin group, and 450 ± 26 kcal in the lifestyle-intervention group (P < 0.001).

·         The participants assigned to the lifestyle intervention had much greater weight loss and a greater increase in leisure physical activity than did participants assigned to receive metformin or placebo. The average weight loss was 0.1, 2.1, and 5.6 kg in the placebo, metformin, and lifestyle-intervention groups, respectively (P < 0.001).

·         The effects of reduction in the incidence of diabetes were similar in men and women and in all racial and ethnic groups. The intensive lifestyle intervention was at least as effective in older participants as it was in younger participants.

 

·         These findings suggest that dietary composition and physical activity are important in diabetes prevention, but their effect on diabetes risk is primarily mediated through resulting weight reduction [23].

 

FDPS [10,20]

 

·         The mean (± SD) amount of weight lost between base line and the end of year 1 was 4.2 ± 5.1 kg in the intervention group and 0.8 ± 3.7 kg in the control group; the net loss by the end of year 2 was 3.5 ± 5.5 kg in the intervention group and 0.8 ± 4.4 kg in the control group.

·         Weight change was significantly associated with the achievement of each of the four lifestyle goals, consequently, success score was strongly and inversely correlated with weight reduction [24].

 

Swedish Malmo Feasibility Study [13,21]

 

·         There was significant weight loss in the intervention group: body weight was reduced by 2.3-3.7%. Weight increased in the reference group by 0.5-1.7% (p ˂ 0.0001).

·         In ˃ 50% of the participants’ glucose tolerance was normalized.

·         At the end of the study, (95% CI 0.3-1.0).

·         In the intervention group, after completing the trial, blood pressure, lipids, and hyperinsulinaemia were reduced.

·         More than 50% of the diabetic patients were in remission at 6-year follow-up.