Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study

Pan, Xiao Ren; Li, Guang Wei; Hu, Ying; Wang, Ji Xing; Yang, Wenying; An, Zuo Xin; Hu, Ze Xi; Lin, Juan; Xiao, Jian; Cao, Hui; Liu, Ping An; Jiang, Xi; Jiang, Ya Yan; Wang, Jin Ping; Zheng, Hui; Zhang, Hui; Bennett, Peter H.; Howard, Barbara V.

doi:10.2337/diacare.20.4.537

Cited by 3,633 publications

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“…Among 577 subjects with IGT in Da Qing study (Pan et al, 1997), exercise interventions, dietary interventions or both resulted in a decreased of 42-46% in the rate of progression from IGT to DM during the 6-y follow-up. The Finnish Diabetes Prevention Program reported that diet (low in saturated and trans fat, high in fiber) and lifestyle modification (small reduction (less than 4.5 kg) in weight and regular moderate exercise) reduced the incidence of type II DM by 58% during 3.2 y of follow-up among 522 middle-aged, overweight subjects with IGT (Tuomilehto et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

“…It is worth noting about some results of the primary prevention of type II DM (Pan et al, 1997;Tuomilehto et al, 2001;Diabetes Prevention Program Research Group, 2002;Hu et al, 2002). Among 577 subjects with IGT in Da Qing study (Pan et al, 1997), exercise interventions, dietary interventions or both resulted in a decreased of 42-46% in the rate of progression from IGT to DM during the 6-y follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores

Kuo

et al. 2004

Eur J Clin Nutr

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Aim: To compare the insulin sensitivity indices between Chinese vegetarians and omnivores. Methods: The study included 36 healthy volunteers (vegetarian, n ¼ 19; omnivore, n ¼ 17) who had normal fasting plasma glucose levels. Each participant completed an insulin suppression test. We compared steady-state plasma glucose (SSPG), fasting insulin, the homeostasis model assessment for insulin sensitivity (HOMA-IR and HOMA %S) and b-cell function (HOMA %b) between the groups. We also tested the correlation of SSPG with years on a vegetarian diet. Results: The omnivore subjects were younger than the vegetarians (55.773.7 vs 58.673.6 year of age, P ¼ 0.022). There was no difference between the two groups in sex, blood pressure, renal function tests and lipid profiles. The omnivores had higher serum uric acid levels than vegetarians Conclusions:The vegetarians were more insulin sensitive than the omnivore counterparts. The degree of insulin sensitivity appeared to be correlated with years on a vegetarian diet.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores

Kuo

et al. 2004

Eur J Clin Nutr

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“…Evidence on type 2 diabetes prevention strategies is extensive, 1,[14][15][16] and currently, clinicians in the United States seeking to help patients reduce their diabetes risk recommend lifestyle change and monitor weight, fasting glucose, and/or HbA1c levels periodically. Among persons undergoing lifestyle change, we show that greater weight loss at 6 months predicts decreased 3-year diabetes risk in a graded fashion and that achievement of fasting glucose <100 mg/dl at 6 months is beneficial regardless of weight loss.…”

Section: Discussionmentioning

confidence: 99%

Early Response to Preventive Strategies in the Diabetes Prevention Program

Maruthur

Delahanty

et al. 2013

J GEN INTERN MED

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BACKGROUND:Recommendations for diabetes prevention in patients with prediabetes include lifestyle modification and metformin. However, the significance of early weight loss and glucose measurements when monitoring response to these proven interventions is unknown. OBJECTIVE: To quantify the relationship between early measures of weight and glucose and subsequent diabetes in patients undergoing diabetes prevention interventions. DESIGN: Analysis of results from a randomized controlled trial in 27 academic medical centers in the United States. PARTICIPANTS/INTERVENTIONS: 3,041 adults with hyperglycemia randomized to lifestyle (n=1,018), metformin (n=1,036), or placebo (n=987) with complete follow-up in The Diabetes Prevention Program. MAIN MEASURES: Independent variables were weight loss at 6 and 12 months; fasting glucose (FG) at 6 months; hemoglobin A1c (HbA1c) at 6 months; and post-load glucose at 12 months. The main outcome was time to diabetes diagnosis. KEY RESULTS: After 6 months, 604 participants developed diabetes in the lifestyle (n=140), metformin (n=206), and placebo (n=258) arms over 2.7 years. In the lifestyle arm, 6-month weight loss predicted decreased diabetes risk in a graded fashion: adjusted HR (95 % CI) 0.65 (0.35-1.22), 0.62 (0.33-1.18), 0.46 (0.24-0.87), 0.34 (0.18-0.64), and 0.15 (0.07-0.30) for 0-<3 %, 3-<5 %, 5-<7 %, 7-<10 %, and ≥10 % weight loss, respectively (reference: weight gain). Attainment of optimal 6-month FG and HbA1c and 12-month post-load glucose predicted >60 % lower diabetes risk across arms. We found a significant interaction between 6-month weight loss and FG in the lifestyle arm (P=0.038). CONCLUSION: Weight and glucose at 6 and 12 months strongly predict lower subsequent diabetes risk with a lifestyle intervention; lower FG predicts lower risk even with substantial weight loss. Early reduction in glycemia is a stronger predictor of future diabetes risk than weight loss for metformin. We offer the first evidence to guide clinicians in making interval management decisions for high-risk patients undertaking measures to prevent diabetes.

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“…Intervention studies have demonstrated that lifestyle changes including increased physical activity can reduce the incidence of diabetes among individuals with impaired glucose tolerance (IGT) [1][2][3]. However, it is unknown whether these results can be extrapolated to individuals with isolated impaired fasting glucose (i-IFG) [4].…”

Section: Introductionmentioning

confidence: 99%

Differential relationship between physical activity and progression to diabetes by glucose tolerance status: the Inter99 Study

Engberg

Glümer²,

Witte

et al. 2009

Diabetologia

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Aims/hypothesis The aim of the study was to analyse how strongly commuting and leisure-time physical activity affect progression to diabetes and to study whether this relationship is different in individuals with isolated impaired fasting glucose (i-IFG) and isolated impaired glucose tolerance (i-IGT). Methods We studied the incidence of diabetes in 4,031 individuals without diabetes at baseline who participated in the baseline and 5 year follow-up examinations of a population-based primary prevention study, the Inter99 Study. Glucose tolerance status at baseline and at followup were based on OGTTs. Commuting and leisure-time physical activity at baseline were assessed by questionnaire. We present rate ratios from Poisson regression analyses adjusted for relevant confounders. Results The progression rate to diabetes was lower among physically active individuals in the total study population and particularly among those with i-IGT. The associations were attenuated and lost statistical significance after further adjustment for BMI. We observed no impact of physical activity on the progression to diabetes in individuals with i-IFG. Conclusions/interpretation Physical activity was associated with a lower progression to diabetes in the total study population and in individuals with i-IGT, a condition primarily characterised by muscle insulin resistance. Physical activity did not predict progression to diabetes in individuals with i-IFG, a condition primarily characterised by hepatic insulin resistance. Our results suggest that there is a differential relationship between physical activity and progression to diabetes among those with i-IFG and i-IGT. Therefore, clinical trials testing the effect of physical activity on progression from i-IFG to diabetes are needed.

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Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study

Abstract: Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT.

Cited by 3,633 publications

References 0 publications

Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores

Insulin sensitivity in Chinese ovo-lactovegetarians compared with omnivores

Early Response to Preventive Strategies in the Diabetes Prevention Program

Differential relationship between physical activity and progression to diabetes by glucose tolerance status: the Inter99 Study

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