Stepwise program can reduce diabetes incidence
Mary Beth Weber, Ph.D., M.P.H., from Emory University in Atlanta, and colleagues conducted a randomized trial involving 578 overweight/obese Asian Indian adults with isolated impaired glucose tolerance (iIGT), isolated impaired fasting glucose (iIFG), or IFG+IGT. Participants were randomized to standard lifestyle advice or to a six-month culturally-tailored U.S. Diabetes Prevention Program-based lifestyle curriculum plus addition of metformin for those at highest risk of conversion to diabetes.
The researchers found that 34.9 percent of control and 25.7 percent of intervention participants developed diabetes during three years of follow-up (P = 0.014). The relative risk reduction (RRR) was 32 percent; in order to prevent one case of diabetes, the number needed to treat was 9.8. There was variation in RRR by prediabetes type (IFG+IGT, 36 percent; iIGT, 31 percent; and iIFG, 12 percent); participants aged 50 years or older, males, and obese had stronger RRR. In addition to lifestyle, 72 percent of participants also required metformin; however, there was some variability by prediabetes type (iIFG, 76.5 percent; IFG+IGT, 83.0 percent; iIGT, 51.3 percent).
"Stepwise diabetes prevention in people with prediabetes can effectively reduce diabetes incidence by a third in community settings; however, people with iIFG may require different interventions," the authors write.
The study was supported by a BRiDGES grant, which was funded by Lilly Diabetes.
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