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Diabetes Risk Factors: Genetics, Obesity, and More

Last updated on 12/18/2020

Losing a few kilograms nearly halves the risk of diabetes; a large scale research study finds

According to the Norfolk Diabetes Prevention Study (NDPS) results, the most extensive diabetes prevention research study globally in the last 30 years, providing support to prediabetic people by making modest changes to their lifestyle, diet regime, and physical activity can nearly halve the risk of developing type 2 diabetes.

The NDPS clinical trial findings, which continued over eight years and included more than 1,000 people with prediabetes at tremendous risk of developing type 2 diabetes, have just been published in the international journal JAMA Internal Medicine.

Physical activity can help overcome the risk of Type 2 diabetes.

The study found that aid to make modest lifestyle changes, including losing two to three kilograms of weight and enhanced physical activity over two years, lessened the risk of type 2 diabetes by 40 to 47 percent for those characterized as having prediabetes.

Nearly eight million people with prediabetes in the UK and 4.5 million have already developed type 2 diabetes. The NDPS, financed by £2.5m from the National Institute for Health Research (NIHR), and NIHR CRN Eastern, was directed by the Norfolk and Norwich University Hospital (NNUH) and University of East Anglia (UEA), collectively with colleagues from Ipswich Hospital and the Universities of Birmingham and Exeter.

The research trial examined a simple lifestyle intervention, which helped people make small achievable lifestyle changes that led to modest weight loss and physical activity increases. These changes were significant for at least two years. These findings are vital as they confer that a “real-world” lifestyle program truly can make a difference in helping people lessen their risk of type 2 (adult-onset) diabetes.

Preventing diabetes by lifestyle change

According to Professor Mike Sampson, NDPS Chief Investigator and Consultant in Diabetes at NNUH, this trial’s results are very delightful. According to him, no one was very certain if a real-world lifestyle program prevented type 2 diabetes in the prediabetes population we studied. There have been no clinical examinations that had shown this. We have now established a significant effect on type 2 diabetes prevention. It is very optimistic that even a modest weight loss and an increase in physical activity in real-world programs like this significantly affect the risk of getting type 2 diabetes; this is excellent news for the eight million people in the UK with prediabetes diagnosis. This test confirms that diabetes prevention is achievable in the same prediabetes populations currently treated in the NHS national diabetes prevention program. It is essential to know that the clinical methods for diagnosing diabetes and prediabetes have changed a lot in recent years.

Optimistic test results

The Norfolk Diabetes Prevention Study operated with 135 GP practices in the East of England was conducted between 2011 and 2018 and found 144,000 people at risk of developing type 2 diabetes. Thirteen thousand of these people took fasting glucose and HbA1c blood tests to detect prediabetes in screening sites across the East of England. Over 1,000 people with prediabetes were then joined into a randomized controlled trial, examining a practical, real-world lifestyle interference, compared to a control group, with an average follow-up of just over two years. Earlier studies have used quite substantial and expensive research interventions in diverse groups of prediabetes participants. However, it’s the first time a real-world group addressed intervention has reduced type 2 diabetes risk.

NDPS also proposed lay members of the public who had type 2 diabetes to help assist participants with prediabetes in the trial. However, this did not additionally reduce the risk of getting type 2 diabetes for this particular population.

A breakthrough in averting type 2 diabetes

According to Max Bachmann, NDPS co-investigator and Professor of Health Services Research at the University of East Anglia, “We delivered the NDPS intervention in groups which were far less expensive than individual-focused interventions. Earlier, these interventions have shown to be effective under optimal conditions. A real breakthrough is that for 1 out of every 11 people who received the NDPS intervention was averted from getting type 2 diabetes.”

Colin Greaves, a Professor of Psychology Applied to Health at the University of Birmingham, jointly led the NDPS intervention development. According to Professor Greaves, “If you have been diagnosed with prediabetes, this strategy extends a way to take a different course in your life. It also helps to get off the path to type 2 diabetes and onto the road to a healthier future.”

Adding to it, Dr. Jane Smith, an NDPS associate from the University of Exeter, said: “Type 2 diabetes is a tremendous health challenge globally. NDPS is an astonishingly positive story for individuals and healthcare systems, and emphasizes the significance of providing national diabetes prevention programs, which can utilize our research conclusions.”

As per Professor Jonathan Valabhji, national clinical director for Diabetes and Obesity: “This study with similar referral criteria and similar intensive lifestyle intervention to the NHS Diabetes Prevention Program has outdone expectations in restricting type 2 diabetes. It is hugely inspiring for the NHS Diabetes Prevention Program, and what participants might expect to gain in the longer term.”

Dr. Elizabeth Robertson, who is serving as the director of research at Diabetes UK, welcomes this new research that shows a group-based support program can aid people at high risk of developing type 2 diabetes and reduce their risk. This trial again highlights how accomplishing modest weight loss through diet, and physical activity changes can lead to tremendous gains for people at high risk of developing type 2. Type 2 diabetes is a severe condition, but many cases can be prevented or delayed with the right help. Diabetes UK’s Know Your Risk tool helps people to determine their risk and take steps to reduce it, including by self-referring on to NHS England’s Diabetes Prevention Program in their local area.”

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