Those at high risk for developing type 2 diabetes may be able to earn themselves a reprieve. According to the Diabetes Prevention Program Outcomes Study (a follow-up to the original Diabetes Prevention Program, or DPP), moderate lifestyle modifications over 10 years can reduce the risk of developing diabetes by 34% compared with a placebo. Put another way, such changes can delay the onset of diabetes in high-risk individuals for about 4 years. By comparison, a group taking an anti-diabetic drug (metformin) can expect to decrease their risk of developing the illness by just 18%, gaining an average delay of only 2 years.

The research was published in the November 14 issue of The Lancet (2009; 374 [9702], 1677–86) and involved 2,766 subjects (88% of the people who completed the DPP). All DPP enrollees were at high risk for developing diabetes. All were considered overweight or obese and had high blood glucose
levels. After 3 years of intensive lifestyle changes (increased levels of physical activity and modest weight loss), the participants had reduced their chances of
developing diabetes by 58%.
For those on metformin, the risk had dropped by 31%.

Prior to the follow-up study, continuing subjects participated in 16 educational lifestyle modification classes. Approximately 7 years later, it was clear that the lifestyle interventions were still having a positive effect. The benefits were especially pronounced among older subjects: those aged 60 or older lowered their rate of diabetes development by 50% during the 10-year span.

“The fact that we’ve continued to delay and possibly even prevent diabetes in people at very high risk for developing the disease is certainly a positive finding,” stated lead researcher Jill Crandall, MD, associate professor of clinical medicine at Albert Einstein College of Medicine at Yeshiva University.