Eating well and living an active lifestyle can stave off kidney disease for diabetics, says study.
Healthy eating, staying active and losing weight are already recommended for people with type-2 diabetes, and new research suggests these steps may also delay or prevent chronic kidney disease.
About 35% of American adults with diabetes have some degree of kidney disease, and diabetes is the major cause of kidney failure and dialysis, according to the study’s lead author Dr William C Knowler.
“This result, along with many others, tends to reinforce the value of weight loss interventions and hopefully motivates people with diabetes to lose weight,” says Knowler, who is chief of the Diabetes Epidemiology and Clinical Research Section of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland.
He and his co-authors re-examined data from an existing study of lifestyle modifications for people with type-2 diabetes.
For the original study, people with type-2 diabetes aged 45 to 76 were divided into two groups. Half received diabetes support and education and the other half aimed to lose 7% of their body weight through reduced calorie diets and increased physical activity.
For the first year or so, the weight-loss group met regularly with dieticians, case managers and physical activity experts to stay on track toward their calorie, activity and weight-loss goals. As with many weight loss programmes, the first year is the critical period for weight loss and later years are spent maintaining it, which can be difficult, Knowler says.
At the one-year mark, the diet and exercise group had lost an average of 8.6% of their body weight, compared to less than one percent in the support-and-education group.
Over the entire study period, people in the diet and exercise group were 31% less likely to develop very high-risk chronic kidney disease, according to urine tests.
The researchers found that the weight loss programme improved the outlook for kidney disease and many other aspects of health, including depression, knee pain, urinary incontinence and heart rate recovery after exercise.
Dr Dick de Zeeuw, of the Hiddo Lambers Heerspink Department of Clinical Pharmacy and Pharmacology at the University of Groningen in Germany, says that the results reinforce the existing recommendation that people with type-2 diabetes should maintain a healthy weight.
“In one sense it doesn’t add anything to existing recommendations because for overweight people, weight loss and increased activity are recommended already,” Knowler says. “But we don’t really put a lot of force behind that recommendation.”
For most people, telling them to lose weight and handing out some pamphlets is not enough, he adds. This study indicates that an intense programme of major behavioural change, including counselling, group session and mutual reinforcement can work.
“Any approach that results in sustained weight loss should work just as well,” Knowler says. – Reuters
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