Lifestyle changes cut diabetes risk in high-risk patients

(HealthDay)—Comprehensive lifestyle interventions decrease the incidence of type 2 diabetes in high-risk patients, but the benefits are less clear in diagnosed patients, according to a review published in the Oct. 15 issue of the Annals of Internal Medicine.

Elizabeth Sumamo Schellenberg, M.P.H., from the University of Alberta in Edmonton, Canada, and colleagues reviewed the literature and conducted a meta-analysis of nine randomized, controlled trials with patients at risk for diabetes and 11 including patients with diabetes to examine the effectiveness of lifestyle interventions. In all trials, lifestyle interventions (at least three months duration) such as exercise, diet, and at least one other component were compared with standard care.

The researchers found that based on seven studies, the risk of diabetes was decreased with lifestyle interventions, from the end of the intervention to up to 10 years after the intervention. Two trials (which included pharmacotherapy) involving patients with diabetes reported no improvement in all-cause mortality. Pooling of composite outcomes for cardiovascular disease was hindered by heterogeneity. At 13 years' follow-up one trial reported improvement in microvascular outcomes.

"Comprehensive lifestyle interventions effectively decrease the incidence of type 2 diabetes in high-risk patients," the authors write. "In patients who have already been diagnosed with type 2 diabetes, the evidence of benefit of comprehensive lifestyle interventions on patient-oriented outcomes is less clear."

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