Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus

Abstract

Analysis 2.4. Comparison 2 Diet plus physical activity versus comparator, Outcome 4 All-cause mortality: age. . . Analysis 2.5. Comparison 2 Diet plus physical activity versus comparator, Outcome 5 All-cause mortality: sex. . . Analysis 2.6. Comparison 2 Diet plus physical activity versus comparator, Outcome 6 All-cause mortality: ethnicity. . Analysis 2.7. Comparison 2 Diet plus physical activity versus comparator, Outcome 7 All-cause mortality: obesity. . Analysis 2.8. Comparison 2 Diet plus physical activity versus comparator, Outcome 8 Incidence of type 2 diabetes. . Analysis 2.9. Comparison 2 Diet plus physical activity versus comparator, Outcome 9 Incidence of type 2 diabetes: duration of the intervention.

Predictors of weight reduction and maintenance in a large cohort of overweight and obese adults in a community setting

“…Although our research design could not relate to reasons explaining this finding, it might relate to the higher lean body mass and metabolic rate typical to younger people, which accelerate weight reduction. Contrary to our findings, previous studies found older age as a predictor of successful weight reduction and maintenance, probably due to higher motivation, fewer competing demands and more medical triggers . For example, in the Look AHEAD and in the TONE trial with cohort mean ages of 59 and 66, respectively, weight loss was associated with improved control of obesity co‐morbidities …”

“…A possible explanation is that when subjects lose large amount of fat they experience favourable changes in their body shape and motivation, and are thus more motivated to maintain weight . The literature, however, is inconsistent regarding this issue: similar to our results, many studies reported higher baseline BMI as a significant predictor of success in weight reduction and maintenance during short and long follow up periods . However, it was also reported that at extreme baseline BMI (above 35) the probability of weight loss and maintenance success declines…”

“…Our study did not find statistically significant associations of any of the demographic factors with high successful weight reduction and maintenance, including marital status, socioeconomic status, ethnic background and gender (using the final multivariate analysis). Previous studies examining the association of demographic parameters with weight reduction outcomes showed inconsistent results for marital status, socioeconomic status, ethnic background and gender . Thus, further research is needed to clarify the link between demographic characteristics and weight reduction and maintenance outcomes.…”

How do we identify people at high risk of Type 2 diabetes and help prevent the condition from developing?

“…Type 2 diabetes risk in the US DPP was found to decrease with moderate weight loss; every 1-kg decrease in weight in the lifestyle arm was associated with a 16% reduction in future Type 2 diabetes incidence [29]. A recent Cochrane systematic review and meta-analysis [30] of 11 RCTs including 4511 participants demonstrated a 43% reduction in risk (95% CI 36-50) over a mean follow-up of 3.8 years.…”

Follow‐up study found that vitamin D deficiency and weight gain increased the risk of impaired fasting glycaemia

“…The association between vitamin D deficiency and weight gain with IFG was not affected by supplements in our study, but reduced sun exposure, unhealthy food and sedentary behaviour may affect vitamin D levels and diabetes risks …”