Nisa M. Maruthur, MD, assistant professor of medicine, The Johns Hopkins School of Medicine and the Welch Center for Prevention, Epidemiology, and Clinical Research, both in Baltimore. Her study was published in Journal of General Internal Medicine.
If your doctor ever tells you (or has already told you) that you have prediabetes, you’d be wise to consider it a serious red flag. It means that your blood sugar level is higher than normal—though not yet quite high enough to be classified as diabetes—because your pancreas isn’t making enough insulin and/or your cells have become resistant to the action of insulin.
A whopping 35% of American adults now have prediabetes. Nearly one-third of them will go on to develop full-blown diabetes, with all its attendant risks for cardiovascular problems, kidney failure, nerve damage, blindness, amputation and death.
That’s why researchers have been working hard to figure out the best way to keep prediabetes from progressing to diabetes. And according to an encouraging new study, one particular approach involving some fairly quick action has emerged as the winner—slashing prediabetic patients’ risk for diabetes by an impressive 85%…without relying on drugs.
The new study draws on data from the national Diabetes Prevention Program, the largest diabetes prevention study in the US, which began back in 1996. The program included 3,041 adults who had prediabetes and were at least somewhat overweight.
Participants were randomly divided into three groups. One group was given a twice-daily oral placebo and general lifestyle modification recommendations about the importance of healthful eating, losing weight and exercising. A second group was given twice-daily oral metformin (a drug that prevents the liver from producing too much glucose) and those same lifestyle recommendations. The third group was enrolled in an intensive lifestyle-modification program, with the goal of losing at least 7% of their body weight and exercising at moderate intensity for at least 150 minutes each week.
The original analysis of the data, done after 3.2 years, showed that intensive lifestyle modification reduced diabetes risk by 58% and metformin use reduced diabetes risk by 31%, as compared with the placebo group.
Updated analysis: Researchers wanted to know whether those odds could be improved even further, so they did a new analysis, this time looking specifically at what happened in the first six months after prediabetes patients began treatment and then following up for 10 years. What they found…
* At the six-month mark, almost everyone (92%) in the intensive lifestyle-modification group had lost weight…while more than 25% in the metformin group (and nearly 50% in the placebo group) had gained weight. The average percentage of body weight lost in each group was 7.2% in the lifestyle group…2.4% in the metformin group…and 0.4% in the placebo group. Ten years later, most of those in the lifestyle group had maintained their substantial weight loss—quite an accomplishment, given how common it is for lost pounds to be regained.
* In the intensive lifestyle-modification group, those who lost 10% or more of their body weight in the first six months reduced their diabetes risk by an impressive 85%. But even those who fell short of the 7% weight-loss goal benefited. For instance, those who lost 5% to 6.9% of their body weight reduced their risk by 54%…and those who lost just 3% to 4.9% reduced their risk by 38%.
If you have prediabetes: Don’t assume that diabetes is an inevitable part of your future…and don’t assume that you necessarily have to take drugs. By taking action now, you can greatly reduce your risk of developing this deadly disease. So talk with your doctor about joining a program designed to help people with prediabetes adopt healthful dietary and exercise habits that will promote safe, speedy and permanent weight loss. Ask your doctor or health insurer for a referral…or click here to find a YMCA Diabetes Prevention Program near you.