For prediabetics: You can prevent diabetes

Just losing a couple of kilos and keeping it off can help prevent the development of diabetes in someone with prediabetes. —

Losing a few kilograms in weight almost halves the risk of developing type 2 diabetes mellitus, finds research led by the Norfolk and Norwich University Hospital (NNUH) and the University of East Anglia (UEA) in the United Kingdom.

The findings, published in the journal JAMA Internal Medicine, come from the Norfolk Diabetes Prevention Study (NDPS) – the largest study on preventing diabetes in the world over the last 30 years.

The clinical trial ran over eight years and involved more than 1,000 people with prediabetes at high risk of developing type 2 diabetes.

It found that support to make modest lifestyle changes, resulting in the loss of two to three kilograms of weight and increased physical activity over two years, reduced the risk of type 2 diabetes by 40% to 47% for those categorised as having prediabetes.

Importantly, these changes were sustained for at least two years and the weight lost was not put back on.

These findings are important as they show that a “real-world” lifestyle programme can really make a difference in helping people reduce their risk of type 2 diabetes.

Chief investigator and NNUH diabetes consultant Professor Dr Mike Sampson said: “We are delighted with the results of this trial, as until now, no one was very sure if a real-world lifestyle programme prevented type 2 diabetes in the prediabetes population we studied, as there have been no clinical trials that had shown this.

“We have now shown a significant effect in type 2 diabetes prevention, and we can be very optimistic that even a modest weight loss and an increase in physical activity in real-world programmes like this have a big effect on the risk of getting type 2 diabetes.”

The study ran between 2011 and 2018, and worked with 135 general practitioner (GP) practices in the east of England.

A total of 144,000 people at risk of developing type 2 diabetes were found.

In screening sites across the area, 13,000 of those people then took a fasting glucose and glycosylated haemoglobin (HbA1c) blood test to detect prediabetes.

More than 1,000 people with confirmed prediabetes were then entered into the randomised controlled trial, testing the lifestyle intervention against a control group, with an average follow-up of just over two years.

Earlier studies have used quite intense and expensive research interventions in different groups of prediabetes participants, but this is the first time a pragmatic intervention has been shown to reduce the risk of type 2 diabetes.

The researchers also asked diabetics (who were not healthcare professionals) to help support the participants during the trial, but this did not further reduce the participants’ risk of getting type 2 diabetes.

Co-investigator Prof Max Bachmann, from UEA’s Norwich Medical School, said: “The NDPS intervention was delivered in groups, which was far less expensive than the individual-focused interventions that have previously been shown to be effective under optimal conditions.

“For every 11 people who received the NDPS intervention, one person was prevented from getting type 2 diabetes, which is a real breakthrough.”

Prof Colin Greaves from the University of Birmingham, who jointly led the development of the NDPS intervention, said: “If you have been diagnosed with prediabetes, this approach offers a way to take a different direction in your life – to get off the path to type 2 diabetes and onto the road to a healthier future.”

Meanwhile, Diabetes UK research director Dr Elizabeth Robertson said: “We welcome this new research showing that a group-based support programme can help people at high risk of developing type 2 diabetes reduce their risk.

“This trial again highlights how achieving modest weight loss through diet and physical activity changes can lead to huge benefits for people at high risk of developing type 2 diabetes.

“It is a serious condition, but with the right help, many cases can be prevented or delayed.

The NDPS, funded by £2.5mil (RM13.6mil) from the UK National Institute for Health Research (NIHR) and NIHR CRN Eastern, was led by NNUH and UEA, working with colleagues from Ipswich Hospital, and the Universities of Birmingham and Exeter.

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