Diet, Exercise Thwart Diabetes: Study

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In the first year of the trial, people in the lifestyle group lost an average of 15 pounds, regaining all but about five pounds over 10 years. People on metformin maintained a five-pound weight loss, and those on placebo lost less than two pounds over 10 years, the researchers note.

Over 10 years, after all the participants made lifestyle changes, the yearly diabetes incidence rates for the drug and placebo groups had dropped to about 5 to 6 percent, the same rate as the lifestyle group.

"Lifestyle intervention, even when provided later, also seemed to lower diabetes incidence rate," Knowler said.

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But losing weight is difficult, and simply telling someone to slim down won't work, he acknowledges.

"To make things like this happen on a large scale, we have to do more than simply tell people to lose weight," he said. People need access to weight loss clinics that can teach them about diet and exercise, he added.

Dr. Anoop Misra, director of the department of diabetes and metabolic diseases at Fortis Hospitals in India, and author of an accompanying journal editorial, said that "prevention of diabetes is important to curb epidemic of diabetes globally. Diet and exercise remain the most important modalities to prevent diabetes, and any drugs are less important."

At-risk groups of diabetes need to be identified, especially certain ethnic groups, and taught proper lifestyle management strategies, Misra said. "Young adults with family history of diabetes should be carefully managed along the same lines," he said.

Diabetes prevention makes economic sense as well, by decreasing costly, lifelong expenditures on management of the disease and its complications, Misra said.

All nations, particularly developing countries, seeing a rapid rise in diabetes should devise or strengthen a national diabetes-control program to help curb the epidemic, he said.

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