To Lower Risk of Diabetes Commit to Diet and Exercise

Health Writer

If you need a strong motivator to get you to realize that preventing type 2 diabetes is hugely possible and within your grasp, despite being at high risk, then the latest study is a true cheerleader.  The 15-year study, which looked at preventing diabetes in high-risk individuals, evaluated the performance of diet and exercise versus a very popular first line treatment of type 2 diabetes, the drug Metformin.  The results showed that diet and exercise together is a powerful and winning combination for people at high risk of diabetes.

The participants in the study were all overweight or suffered with obesity, putting them at high risk for diabetes type 2.  The study had an initial three-year head-to-head comparison of the two treatment tracks, with results that showed diet and exercise superior to Metformin’s impact on reducing risk of diabetes.  Observations then continued over a 15-year period and the low fat, low calorie diet plus daily moderate-intense exercise continued to beat Metformin. Of special interest was the fact that in patients over age 60, the diet and exercise combination therapy showed an even greater disease risk-reduction impact than the Metformin regimen of 850 milligrams, twice daily.

The original three year Diabetes Prevention Program was extended, and the trial continued between 1996 and 2001, involving surviving participants who still wanted to be part of the research. Results from that time period showed that the diet and exercise group had a 58 percent lower risk of having developed diabetes compared to a placebo group.  The Metformin group had a 31 percent lower risk of developing diabetes, compared to a placebo group.

By 2014, about 90 percent of the original participants (2776 individuals) had been followed since the end of the first study, and based on their original treatment plan, were offered lifestyle seminars twice during the year, or to continue to receive Metformin.  After the full 15 years of the research project, diabetes incidence was 27 percent lower in the lifestyle-modification group compared to 18 percent lower in the group that received Metformin.  In 2014, the final statistics included:

  • 55 percent of the lifestyle group had been diagnosed with diabetes
  • 56 percent of the Metformin group had been diagnosed with diabetes
  • 62 percent of the placebo group had been diagnosed with diabetes

The researchers note that though serious lifestyle modification did intercept diabetes risk, it did not always reduce the risk of microvascular changes and blood vessel complications often associated with diabetes.  So they see the benefits of using of Metformin as a tool in diabetes prevention, especially in patients who have obesity and cannot walk or exercise due to physical limitations, or to help those who can’t follow a strict lifestyle program long term.  The study results are incredibly compelling and inspirational if you have serious weight issues and recognize your heightened risk of diabetes.  You have the power to reduce your risk of developing diabetes with simple and healthy habit changes.

Some basic recommendations:

  • Talk to your doctor and request a referral to a dietician or nutritionist
  • Join a gym or have an initial conversation with a personal trainer
  • Put your daily exercise on a calendar so you have a revolving reminder
  • Ask your doctor for an initial low fat, low calorie diet while you arrange for these consultations
  • Keep a food journal so you track food choices, portion sizes, and daily activity
  • Focus specifically on reducing processed, refined carbohydrates and limit animal fats and replace these foods with limited amounts of whole grains, plant-based proteins, and healthier fats
  • Cook more at home so you control ingredients and portion sizes

See more helpful articles:

If Your Doctor Prescribes Fruits and Vegetables, Will You Eat Them?


The Lancet Diabetes and Endocrinology

Reuters Health