June 01, 2018
2 min read

Lifestyle advice alone fails to reduce type 2 diabetes risk

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Among Norwegian adults at high risk for developing type 2 diabetes, twice-yearly group sessions designed to teach lifestyle modifications did not decrease disease risk over 2 years, according to study results.

Anne Jølle, MD, a specialist in family medicine and research fellow in the department of public health and general practice at the Norwegian University of Science and Technology, and colleagues enrolled 2,380 adults (identified through the 2006-2008 HUNT3 Survey of adults living in Nord-Trøndelag County, Norway) without type 2 diabetes but at increased risk for the disease in the DE-PLAN study.

Participants (mean age, 62.7 years; 60.8% women) underwent a baseline physical examination and then attended four 2.5-hour group education sessions at 2, 6, 12 and 24 months after baseline. Sessions covered general information about diabetes and diabetes risk/prevention, nutrition and dietary recommendations, advice on moderate physical activity, and information on physical activity opportunities. HbA1c and fasting and 2-hour oral glucose tolerance test measurements were recorded at each session.

Among the cohort, 50.9% attended at least three of the sessions, with attendance similar between men and women; participants younger than 50 years had moderately higher attendance (58.5%) vs. those aged 50 to 69 years. Those with depressive symptoms had slightly lower rates of attendance (47.4%) vs. those without depression (52.3%).
3.5% of participants received a new diagnosis of diabetes, with 3.1% diagnosed at 12 months and 4% at 24 months, for a 2-year diabetes incidence of 10.3%. From baseline to 24 months, researchers observed overall increases in mean HbA1c (0.3 percentage points), fasting blood glucose rose (0.13 mmol/L) and 2-hour OGTT (0.46 mmol/L; P < .001 for all), as well as BMI (0.3 kg/m2; P < .001).

“The substantial 2-year diabetes incidence, the consistent increases in glycemia and BMI, the relatively low participation, and the low proportion achieving substantial weight reduction indicate that our low-grade intervention with basic lifestyle advice did not have a clinically meaningful effect on diabetes prevention, overall or in subgroups by age, sex, education level, depressive symptoms, BMI, physical activity or family history of diabetes,” the researchers wrote. “Our prevention strategy of informing high-risk individuals about their elevated diabetes risk and providing them with basic lifestyle advice is likely of similar intensity as the preventive measures often offered to high-risk individuals in a primary care setting. However, our strategy appeared ineffective and improved population strategies or more intensive individual-level intervention seems necessary to prevent type 2 diabetes.” – by Jennifer Byrne

Disclosures: The authors report no relevant financial disclosures.