Can Lifestyle Changes Really Prevent Diabetes? Study Provides Insights - Video

In a study published in The Lancet Diabetes & Endocrinology, researchers report that lifestyle modifications remain more effective than medication in preventing the onset of Type 2 diabetes in at-risk individuals.

The findings come from the Diabetes Prevention Program (DPP), a large randomized trial launched in 1996 to compare the effects of the drug metformin with those of an intensive lifestyle intervention, including healthy diet and regular exercise. The trial enrolled 3,234 prediabetic adults at 30 institutions across 22 U.S. states. Researchers found that, while both strategies significantly reduced the risk of developing Type 2 diabetes, the lifestyle intervention showed superior long-term results.

The latest follow-up, called the Diabetes Prevention Program Outcomes Study (DPPOS), involved researchers like Vallabh “Raj” Shah, professor emeritus at The University of New Mexico School of Medicine. According to Shah, “The data suggests that those people who didn't get diabetes also didn't get diabetes after 22 years.”

Initially, the lifestyle changes led to a 58% reduction in diabetes incidence after three years, compared to 31% with metformin. Over the full 22-year span, the lifestyle group saw a 24% reduction in diabetes onset, and the metformin group saw a 17% reduction, compared to placebo. Participants in the lifestyle arm also remained diabetes-free for a median of 3.5 years longer than those in the placebo group, while those on metformin extended that timeline by 2.5 years.

“Within three years, they had to stop the study because lifestyle was better than metformin,” Shah emphasized. “That means lifestyle, which everybody is banking on, is more effective – that is the news.”

Reference: Long-term effects and effect heterogeneity of lifestyle and metformin interventions on type 2 diabetes incidence over 21 years in the US Diabetes Prevention Program randomised clinical trial, Knowler, William CAbbas, Caroline et al. The Lancet Diabetes & Endocrinology, Volume 13, Issue 6, 469 – 481