Diabetes disrupts blood sugar levels A period of careful eating and regular exercise can stave off diabetes for a decade, a study suggests. US researchers followed up nearly 3,000 overweight people who had taken part in a three year diabetes prevention programme. The group had initially been divided into three - assigned either to a diet and exercise programme, the diabetes drug metformin or a placebo. The Lancet report notes it was the dieters who reaped the most benefit. All three groups were given access to ongoing lifestyle coaching once the initial three year trial had ended. That trial, carried out by the US-based Diabetes Prevention Program Research Group, had shown a diet aimed at achieving 7% weight loss, combined with half an hour of exercise five days a week, reduced the risk of developing Type 2 diabetes by 58% compared with the placebo group. The group on metformin, a drug which has been used to treat the condition since the 1950s, saw their risk decline by nearly a third. We need more effective drugs for people who cannot follow intensive lifestyle therapy because of infirmity

Dr Anoop MisraLancet editorial In the seven years after the trial ended, both the drug and placebo groups - now also eating more carefully and exercising - saw the rate of diabetes fall. But the most significant drop was among those who had started out on a diet and exercise regime - their risk was over a third lower than the placebo group. In an accompanying editorial, Dr Anoop Misra, a specialist in diabetes in New Delhi, described the prevention of the disease as "a long and winding road". 'No short cut' Dr Misra said: "There seems to be no short cut, and a persistent and prolonged intensive lifestyle intervention seems to be the most effective way to travel on it." But he warned it could not be the only measure: "We need more effective drugs for those who cannot follow intensive lifestyle therapy because of infirmity." Type 2 diabetes usually appears in people over the age of 40, however increasing numbers of children are being diagnosed with the condition, some as young as seven. Although obesity is a risk factor, not all people with type 2 diabetes are overweight. Dr Iain Frame, head of research at Diabetes UK, said: "It is fascinating to read about the 10-year follow up studies and of the importance of lifestyle interventions, with or without metformin, in the prevention of Type 2 diabetes even after 10 years. "There is clearly no easy route to take to prevent Type 2 diabetes but indications are that with further research into the long-term benefits of good dietary advice, physical activity and, where necessary drug therapies, we may be a step closer into helping people at high risk of developing Type 2 diabetes modify their lifestyle choices that are sustainable in the longer term."



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