Lifestyle changes effective to prevent/ delay Type 2 diabetes

A lifestyle intervention program of increased physical activity, healthy eating and aiming for weight loss of 7% or more, or taking the medication that is metformin were effective long-term to either delay or prevent Type 2 diabetes in adults with prediabetes. Neither approach, however, reduced the risk of cardiovascular disease for study participants over 21 years of the study. The study here is published in the American Heart Association's Circulation journal.

The study included 3,234 adults who participated in the original, 3-year Diabetes Prevention Program (DPP) trial. The analysis of the study focused on determining whether the medication metformin or lifestyle intervention might reduce the risk of cardiovascular disease or the rate of major cardiac events such as heart attack, stroke or death due to cardiovascular disease.

There was no significant differences in the incidence of heart attacks, stroke or cardiovascular death among the intervention groups. Specifically, the analysis found that there was a continued reduction or delay in the development of type 2 diabetes for up to 15 years. The number of non-fatal heart attacks across each group was similar: 35 heart attacks occurred in the lifestyle intervention group; 46 in the metformin group; and 43 in the placebo group. Similarities were also found in the number of non-fatal strokes: 39 incidences of stroke in the lifestyle intervention group; 16 in the metformin-only group; and 28 in the placebo group. The number of deaths due to cardiovascular occurrences were low: 37 deaths among the lifestyle intervention participants; 39 in the metformin group; and 27 in the participants who took the placebo during the original trial.

The fact that neither a lifestyle intervention program nor metformin led to a decrease in cardiovascular disease among people with prediabetes may mean that these interventions have limited or no effectiveness in preventing cardiovascular disease, even though they are highly effective in preventing or delaying the development of Type 2 diabetes.