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Lifestyle Intervention for the Prevention of Type 2 Diabetes Mellitus

Putting Theory to Practice

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Treatments in Endocrinology

Abstract

Type 2 diabetes mellitus is a serious, growing, and costly public health problem. The disease is chronic and degenerative, and thus primary prevention is desirable. Observational studies have linked type 2 diabetes to specific lifestyle behaviors. Several recent major clinical trials confirm that type 2 diabetes can be delayed or prevented in people at high risk; multicomponent lifestyle modification can reduce the incidence of diabetes up to 58%. The American Diabetes Association has recently recommended that lifestyle interventions to prevent or delay diabetes be delivered to people with prediabetes. Delivery of lifestyle interventions in practice is fraught with challenges, but there are several tools and practical strategies available for the implementation of trial findings.

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References

  1. Narayan KM, Gregg EW, Fagot-Campagna A, et al. Diabetes: a common, growing, serious, costly, and potentially preventable public health problem. Diabetes Res Clin Pract 2000; 50Suppl. 2: S77–84

    Article  PubMed  Google Scholar 

  2. Knowler WC, Narayan KM, Hanson RL, et al. Preventing non—insulin-dependent diabetes mellitus. Diabetes 1995; 44: 483–8

    Article  PubMed  CAS  Google Scholar 

  3. Eriksson KF, Lindgarde F. Prevention of type 2 (non—insulin-dependent) diabetes mellitus by diet and physical exercise: the 6-year Malmo feasibility study. Diabetologia 1991; 34: 891–8

    Article  PubMed  CAS  Google Scholar 

  4. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study. Diabetes Care 1997; 20: 537–44

    Article  PubMed  CAS  Google Scholar 

  5. Tuomilehto J, Lindstrom J, Eriksson JG, et al., for the Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–50

    Article  PubMed  CAS  Google Scholar 

  6. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403

    Article  Google Scholar 

  7. Ford ES, Williamson DF, Liu S. Weight change and diabetes incidence: findings from a national cohort of US adults. Am J Epidemiol 1997; 136: 214–22

    Article  Google Scholar 

  8. Colditz GA, Willett WC, Rotnitzky A, et al. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med 1995; 122: 481–6

    PubMed  CAS  Google Scholar 

  9. Hanson RL, McCance DR, Jacobsson LT, et al. The U-shaped association between body mass index and mortality: relationship with weight gain in a Native American population. J Clin Epidemiol 1995; 48: 903–16

    Article  PubMed  CAS  Google Scholar 

  10. Mayer-Davis EJ, D’Agostino R, Karter AJ, et al. Intensity and amount of physical activity in relation to insulin sensitivity: the Insulin Resistance Atherosclerosis Study. JAMA 1998; 279: 669–74

    Article  PubMed  CAS  Google Scholar 

  11. Kriska AM, Pereira MA, Hanson RL, et al. Association of physical activity and serum insulin concentrations in two populations at high risk for type 2 diabetes but differing by BMI. Diabetes Care 2001; 24(7): 1175–80

    Article  PubMed  CAS  Google Scholar 

  12. Hu FB, Sigal RJ, Rich-Edwards JW, et al. Walking compared with vigorous physical activity and risk of type 2 diabetes in women: a prospective study. JAMA 1999; 282: 1433–9

    Article  PubMed  CAS  Google Scholar 

  13. Helmrich SP, Ragland DR, Leung RW, et al. Physical activity and reduced occurrence of non—insulin-dependent diabetes mellitus. N Engl J Med 1991; 325: 147–52

    Article  PubMed  CAS  Google Scholar 

  14. Manson JE, Rimm EB, Stampfer MJ, et al. Physical activity and incidence of non—insulin-dependent diabetes mellitus in women. Lancet 1991; 338: 774–8

    Article  PubMed  CAS  Google Scholar 

  15. Manson JE, Nathan DM, Krolewski AS, et al. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA 1992; 268: 63–7

    Article  PubMed  CAS  Google Scholar 

  16. Schranz A, Tuomilehto J, Marti B, et al. Low physical activity and worsening of glucose tolerance: results from a 2-year follow-up of a population sample in Malta. Diabetes Res Clin Pract 1991; 11: 127–36

    Article  PubMed  CAS  Google Scholar 

  17. Burchfiel CM, Sharp DS, Curb JD, et al. Physical activity and incidence of diabetes: the Honolulu Heart Program. Am J Epidemiol 1995; 141: 360–8

    Article  PubMed  CAS  Google Scholar 

  18. Lynch J, Helmrich SP, Lakka TA, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non—insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 1996; 156: 1307–14

    Article  PubMed  CAS  Google Scholar 

  19. Haapanen N, Miilunpalo S, Vuori I, et al. Association of leisure time physical activity with the risk of coronary heart disease, hypertension, and diabetes in middle-aged men and women. Int J Epidemiol 1997; 26: 739–47

    Article  PubMed  CAS  Google Scholar 

  20. Folsom AR, Kushi LH, Hong CP. Physical activity and incident diabetes mellitus in postmenopausal women. Am J Public Health 2000; 90: 134–8

    Article  PubMed  CAS  Google Scholar 

  21. Hu FB, van Dam RM, Liu S. Diet and risk of type II diabetes: the role of types of fat and carbohydrate. Diabetologia 2001; 44: 805–17

    Article  PubMed  CAS  Google Scholar 

  22. Pereira MA, Jacobs DR, Van Horn L, et al. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA 2002; 287: 2081–9

    Article  PubMed  Google Scholar 

  23. Narayan KM, Imperatore G, Benjamin SM, et al. Targeting people with prediabetes: lifestyle interventions should also be aimed at people with prediabetes. BMJ 2002; 325: 403–4

    Article  PubMed  Google Scholar 

  24. de Vegt F, Dekker JM, Jager A, et al. Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: the Hoorn Study. JAMA 2001 Apr 25; 285(16): 2109–13

    Article  PubMed  Google Scholar 

  25. American Diabetes Association. National Institutes of Diabetes, Digestive and Kidney Diseases: the prevention or delay of type 2 diabetes. Diabetes Care 2002; 25(4): 742–9

    Article  Google Scholar 

  26. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Q 1984; 11(1): 1–47

    Article  PubMed  CAS  Google Scholar 

  27. Rogers EM. Lessons for guidelines from the diffusion of innovations. Jt Comm J Qual Improv 1995 Jul; 21(7): 324–8

    PubMed  CAS  Google Scholar 

  28. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2001; 23: S5–S20

    Google Scholar 

  29. Stern MP, Williams K, Haffner SM. Identification of persons at high risk for type 2 diabetes mellitus: do we need the oral glucose tolerance test? Ann Intern Med 2002; 136: 575–81

    PubMed  Google Scholar 

  30. Wing RR, Gorin A, Tate D. Strategies for changing eating and exercise behavior. In: Bowman BA, Russell RM, editors. Present knowledge in nutrition. 8th ed. Washington, DC: ILSI Press, 2001: 650–61

    Google Scholar 

  31. Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol 1992; 47(9): 1102–14

    Article  PubMed  CAS  Google Scholar 

  32. Diabetes Prevention Program (DPP) Research Group. The cost-effectiveness of DPP interventions to delay or prevent type 2 diabetes. Diabetes 2002; 51Suppl. 2: A74

    Google Scholar 

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Authors and Affiliations

  1. Division of Diabetes Translation, Chief of Diabetes Epidemiology, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Mailstop K-10, 4770 Buford Highway NE, Atlanta, Georgia, 30341, USA

    K. M. Venkat Narayan & Edward W. Gregg

  2. Rollins School of Public Health, Emory University, Atlanta, Georgia, USA

    K. M. Venkat Narayan

  3. Division of General Internal Medicine, University of California, San Francisco, San Francisco, California, USA

    Alka M. Kanaya

Authors
  1. K. M. Venkat Narayan
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  2. Alka M. Kanaya
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  3. Edward W. Gregg
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Correspondence to K. M. Venkat Narayan.

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Venkat Narayan, K.M., Kanaya, A.M. & Gregg, E.W. Lifestyle Intervention for the Prevention of Type 2 Diabetes Mellitus. Mol Diag Ther 2, 315–320 (2003). https://doi.org/10.2165/00024677-200302050-00003

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