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Lifestyle Interventions in Patients with or at Risk for Type 2 Diabetes

Summary and Comment |
December 17, 2013

Lifestyle Interventions in Patients with or at Risk for Type 2 Diabetes

  1. Jamaluddin Moloo, MD, MPH

In a meta-analysis, lifestyle interventions prevented diabetes, but evidence was insufficient to show benefit in patients with already-diagnosed diabetes.

  1. Jamaluddin Moloo, MD, MPH

Dietary and exercise interventions are effective for preventing diabetes, but evidence is lacking on whether multifaceted lifestyle interventions benefit patients who already have diabetes or are at high risk for developing it. Researchers conducted a systematic review and meta-analysis of 20 randomized, controlled trials in which the effects of diet, exercise, and at least one other component (e.g., counseling, behavior modification, medication) were assessed in patients with diabetes or at high risk for diabetes. Control groups received usual care, educational materials, or various other interventions.

Among high-risk patients, lifestyle interventions were associated significantly with lower risk for progression to diabetes for as long as 10 years after intervention (relative risk, 0.35); data on preventing adverse cardiovascular events and retinopathy were insufficient to evaluate those outcomes. Among patients with type 2 diabetes, lifestyle interventions were not associated with improvements in metabolic outcomes (e.g., blood pressure, lipids) after adjustment for medication use; evidence was insufficient on cardiovascular and microvascular outcomes, and all-cause mortality was similar between intervention and control groups during >10 years of follow-up.

Comment

This meta-analysis showed that lifestyle interventions lowered risk for type 2 diabetes among people at high risk. Among patients already diagnosed with type 2 diabetes, findings were sobering: No reduction in 10-year mortality and insufficient evidence to suggest a benefit for cardiovascular or microvascular outcomes.

  • Disclosures for Jamaluddin Moloo, MD, MPH at time of publication Grant / research support NIH

Citation(s):

Reader Comments (2)

Rafael Niebles Physician, Internal Medicine, Hospital

THERE IS NOT A LINK WITH DIET ? IS DIET TO BE TOLD ? -

Francisco Guajardo Physician, Family Medicine/General Practice, Nuevo Laredo Tam MX

THERE IS NOT A LINK WITH DIET ? IS DIET TO BE TOLD ?

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