Independent and combined effect of diet and exercise in adults with prediabetes

Abstract

Prediabetes is defined as impaired fasting glucose and/or impaired glucose tolerance. Impaired fasting glucose is usually defined as fasting blood glucose between 5.6 mmol/L and 6.9 mmol/L (100.8–124.2 mg/dL), and impaired glucose tolerance is the 2-hour oral glucose tolerance test of 7.8–11.0 mmol/L (140.4–198.0 mg/dL). Most individuals with prediabetes are overweight or obese and are at greater risk of type 2 diabetes (T2D). The first line of treatment for individuals with prediabetes is lifestyle modification, including diet and exercise. The aim of this review, through the revision of primarily randomized control trials, is to discuss the independent and combined effect of diet and exercise on the incidence of T2D, glycemic control, and weight loss in adults with prediabetes. Based on the available literature, lifestyle modification combining both diet and exercise is effective at reducing the incidence of T2D and improving glycemic control, even without a significant reduction in body weight. Thus, it is unclear whether weight loss, through lifestyle modification, is a cornerstone for improving glycemic control in individuals with prediabetes. The independent effect of diet or exercise alone on the improvement in glycemic control and/or reduction in body weight in individuals with prediabetes still requires more studies to draw a clear conclusion, considering the quality and quantity of available studies. As of now, the best diet and/or exercise program to improve glycemic control and body weight in adults with prediabetes is unknown.

Effect of aerobic exercise on insulin resistance and central adiposity disappeared after the discontinuation of intervention in overweight women

“…Previous studies have shown that AE has not only a direct impact on body composition and weight 6 , 7 but also affects insulin resistance. 2 , 3 , 4 The results of the current report were in line with these studies. Our study further showed that in pre- or postmenopausal women, both short- and long-term AE were effective to improve the insulin resistance without significant change in body weight.…”

“…The current public health burdens caused by chronic disease cluster are associated with sedentary lifestyle and unbalanced diet. 1 Studies have shown that increasing individual levels of physical activity (PA) by exercise intervention is effective for reducing insulin resistance 2 , 3 , 4 , 5 and adiposity; 6 , 7 especially among populations with sedentary lifestyle and obesity. 7 However, such studies are still facing the challenge in terms of whether the subjects would maintain the PA level after the discontinuation of the organized exercise and whether the benefit gained from exercise intervention remained after intervention over time.…”

“…To date, the results of whether the benefit from exercise could remain after exercise intervention are still inconclusive. Some studies have shown that lifestyle intervention including exercise can prevent or delay progression to type 2 diabetes, 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 and that effects persist even after the intervention is stopped. 10 , 11 , 12 These positive results are mainly from long-term interventions.…”

Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development

“…Finally, we stress that despite our “triangulation” 71 by integrating interlocking evidence from multiple approaches 72 such as health insurance claims analyses performed on different cohorts by different investigators, cell culture studies, and animal models, we caution against advocating use of NRTIs in prediabetes or diabetes in the absence of prospective randomized clinical trials. Cost-benefit analyses of the future utilization of NRTIs following prospective evaluation should include consideration of their potential for inducing viral resistance as well as how they compare to certain diets and exercise regimens, which can benefit individuals with prediabetes 73 – 75 .…”

Appraisal of Triglyceride-Related Markers as Early Predictors of Metabolic Outcomes in the PREVIEW Lifestyle Intervention: A Controlled Post-hoc Trial

“…Abbreviations: ADA, American Diabetes Association; BMI, body mass index; CID, Clinical Investigation Day; DP, diabetes prevention; EIR, energy intake reported; FPG, fasting plasma glucose; GI, glycemic index; HbA1c, glycosylated hemoglobin; HDL cholesterol, high-density lipoprotein cholesterol; LDL cholesterol, low-density lipoprotein cholesterol; HI, high-intensity; HOMA-IR, homeostatic model assessment of insulin resistance; HP, high protein; LED, low-energy diet; MI, moderate intensity; MP, moderate protein; OGTT, oral glucose tolerance test; PA, physical activity; SOP, Standard Operation Procedure; SBP, systolic blood pressure; DBP, diastolic blood pressure; T2D, Type 2 diabetes mellitus; TG, Triglyceride; TyG, Triglyceride glucose index; TyG-Waist, Triglyceride waist circumference index. Indeed, clinical and epidemiological evidence highlights independent or combined beneficial effects of manipulating dietary patterns (quantity and composition of the nutritional intake) and/or PA (type, intensity, and/or frequency) to improve glucose homeostasis and reduce diabetes incidence in people with pre-diabetes (9)(10)(11). Specifically, previous lifestyle interventions, such as the Chinese Da Qing study, the Finnish Diabetes Prevention Study, and the US, Indian, and Japanese programs have demonstrated evidence in precluding and delaying progression to T2D and associated morbidities (12).…”