Prescribing Advice for GPs

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Diet and exercise prevents diabetes

Lifestyle interventions, including diet and exercise, can prevent the development of diabetes according to a follow-up of the Finnish Diabetes Prevention Study. This paper was published in the Lancet and has also be the subject of a recent InfoPOEM.

The study followed a group of 522 patients (2 women: 1 man) who were overweight (BMI > 25kg/M2) and who had impaired glucose tolerance. They were randomly assigned to intensive lifestyle interventions or usual care. Over the original four years of the study 11% of the intervention arm developed diabetes compared to 23% of the usual care arm. Respectively, in the two groups the incidence of diabetes was 4·3 and 7·4 per 100 person-years; a relative risk reduction of 43%.

This difference continued for a further 3 years of follow up with corresponding incidence rates of 4·6 and 7·2 per 100 person-years; a relative risk reduction of 36%.

The authors conclude that lifestyle interventions reduce the incidence of diabetes and that this effect remains even after individual lifestyle counselling is stopped.

Action: Clinicians should recommend a healthy, balanced diet and increased physical activity to all patients at risk of developing diabetes and regularly reiterate this advice.

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