DPP: Lifestyle Change Reduces Risk of Progression to Diabetes


Weight loss achieved through improved diet and increased physical activity is the key--but how much?

The latest statistics from the Centers for Disease Control and Prevention (CDC) show that 37% of American adults over age 20 and 51% of adults over age 65 have prediabetes. A promising report based on early results from the CDC’s National Diabetes Prevention Program (DPP), now shows that prescribed lifestyle changes may successfully reduce the risk for progression to frank diabetes among those with prediabetes.

The results, published in the April 2017 issue of Diabetes Care, come after the first 4 years of the program, with more benefits observed for those who participate at higher levels.

The National DPP, launched in 2010, is a US-wide effort to prevent T2DM in those at risk through structured lifestyle change programs. One of the program’s goals is to help participants with prediabetes lose between 5% and 7% of body weight. Evidence shows this reduction in body weight greatly reduces the likelihood of progression to T2DM.

The National Institutes of Health developed the program and published the results from a clinical trial on its effects in 2002. Those results showed that people with prediabetes who take part in a structured lifestyle change program can cut their risk of developing T2DM by 58% (71% for people over 60 years old). The program helped people reach the weight loss goal of 5% to 7% of their body weight through healthier eating and 150 minutes of physical activity a week.

In the new study, researchers led by Elizabeth K. Ely performed a descriptive analysis on data from 14,747 adults enrolled in year-long T2DM prevention programs during the period of February 2012 through January 2016. The researchers summarized data on attendance, weight, and physical activity minutes and examined predictors of weight loss.

The participants attended a median of 14 sessions over an average of 172 days in the program (median 134 days). Overall, more than one-third (35.5%) achieved the 5% weight loss goal. The average weight loss was 4.2%, with a median of 3.1%.

The participants reported that they had engaged in a weekly average of 152 minutes of physical activity (median 128 minutes). Some 41.8% met the physical activity goal of 150 minutes per week.

Importantly, for every additional session attended and every 30 minutes of activity reported, the participants lost 0.3% of body weight, which was statistically significant.

“During the first 4 years, the National DPP has achieved widespread implementation of the lifestyle change program to prevent type 2 diabetes, with promising early results. Greater duration and intensity of session attendance resulted in a higher percent of body weight loss overall and for subgroups,” stated the researchers.

They noted that a focus on retention may reduce disparities and improve overall program results. “Further program expansion and investigation is needed to continue lowering the burden of type 2 diabetes nationally,” they stated.

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