Change of behavior to delay the onset of diabetes

A very encouraging study from the Finnish team of J. Tuomilheto et al. shows that it is possible to prevent or delay the onset of diabetes type 2 in persons who are obese and glucose intolerant (the intermediate step between normal functioning and diabetes), by modifying lifestyle. The goals of the intervention are :

Weight reduction > 5 %
Daily intake of fat < 30 %
Daily intake of saturated fat < 10 %
Intake of fibers ³15 g / 1000 kcal
Exercise (aerobic and muscle building) > 4 h / week

Compared to a control group (who had no intervention, n=257), the number of new cases of diabetes was 58% less in the lifestyle change group (n=265). Even though the study was not designed to answer this particular question, it indicates that exercise can protect against diabetes without significant loss of excess weight. No diabetes was found in the 49 subjects who achieved at least 4 of the 5 goals. The editor of the New England Journal of Medicine is correct to wonder if this type of intervention is exportable ! (JJG)
Tumilheto J. et al. Prevention of Type 2 Diabetes Mellitus by changes in Lifestyle amoung Subjects with Impaired Glucose Tolerance. N Engl J Med 2001, 344 : 1343-5 (