March 08, 2016
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Reductions in weight, waist circumference can reverse prediabetes, impaired glucose regulation

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Adults who achieve reductions in weight and waist circumference within 1 year of a diagnosis of prediabetes or intermediate hyperglycemia are twice as likely to return to normal glucose tolerance, study findings show.

In an analysis of participants in a prediabetes cohort study screened annually for type 2 diabetes over 5 years, researchers found that adults who lost 3% of their baseline body weight by 1 year were significantly more likely to regress to normal glucose tolerance vs. those who maintained their baseline weight or gained weight.

Danielle Boadicoat

Danielle Bodicoat

“This study emphasizes the importance of encouraging people with raised glucose levels (intermediate hyperglycemia) to make healthy lifestyle choices that will increase their chances of returning to normal glucose levels, instead of only focusing on delaying the development of diabetes, which tends to be current clinical practice,” Danielle Bodicoat, PhD, a lecturer in epidemiology at the University of Leicester, United Kingdom, told Endocrine Today. “Our findings suggest that losing weight or reducing your waist circumference may be the most important part of this; any reduction in body size within 1 year of diagnosis of intermediate hyperglycemia appeared to double the chance of returning to normal glucose levels.”

Bodicoat and colleagues analyzed data from 817 adults with a diagnosis of impaired fasting glucose or impaired glucose tolerance at baseline participating in the ADDITION-Leicester study (mean age, 60 years; 53% women; 61% white; mean HbA1c, 5.9%). Within the cohort, 68% had IGT; 18% had IFG; 14% had both. Participants were screened annually for type 2 diabetes for 5 years or until diabetes diagnosis. Researchers used logistic regression models to investigate modifiable risk factors for regression to normal glucose tolerance at 1 year; Cox regression models estimated subsequent diabetes risk (n = 630).

At 1 year, 54% of participants regressed to normal glucose tolerance; 40.3% still had impaired glucose regulation; 5.8% had developed type 2 diabetes.

After adjustment, researchers found that participants who lost a mean of 3% of their baseline weight by 1 year (18.6%) were significantly more likely to regress to normal glucose tolerance than those who maintained their weight or lost weight (adjusted OR = 1.81; 95% CI, 1.08-3.03). Researchers also found a significant benefit among participants who lost more than 3 cm of baseline waist circumference (adjusted OR = 1.78; 95% CI, 1.03-3.06). Regression to normal glucose tolerance was not associated with changes in physical activity, alcohol consumption or statin treatment (P > .05 for all); diet was not measured.

Those with normal glucose tolerance at 1 year were more likely to remain diabetes-free than those with impaired glucose regulation at 1 year (adjusted HR = 0.19; 95% CI, 0.1-0.37). – by Regina Schaffer

For more information:

Danielle Bodicoat, PhD, can be reached at the Diabetes Research Center, University of Leicester, Leicester General Leicester, LE5 4PW, United Kingdom; email: dhm6@le.ac.uk

Disclosure: The researchers report no relevant financial disclosures.

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