Ready for the secret? OK, here goes:
Lose weight, eat well and exercise!
Oh, sorry, you already knew that? And it seems pretty obvious as well? And yet, if everyone knows this, then why is diabetes the epidemic that it is?
怎么办？
Ah, human nature. If everyone did what doctors told them to, then I’d be out of a job!
We can talk all day about human nature and motivation, but it is important that people realize that weight, diet and exercise is, by far, the #1 way to fend off diabetes. It was proven in the landmark 2002 study Diabetes Prevention Program, where the rate of new diabetes fell by 58% with intensive lifestyle intervention and by 31% with metformin only. Put another way, lifestyle intervention — which included diet modification, exercise, and weight-reduction targets — lowered the new diabetes rate 39% better than prescription medicines. That’s impressive stuff, and should be powerful motivators for people to take control of their health.
Now, that same study has an updated study, published in Lancet this week, which continued to follow the same patients, for a total of 10 years. And the good news is that continuing their lifestyle changes still lowered their risk for diabetes. Their conclusion is powerful stuff: “Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years.” There is a good review of this study here (Lifestyle Modification, Metformin Diabetes Prevention Long-Term Follow-Up), from Medscape. Here’s a good quote from the editorial:
“What does this study add?” asks Dr Anoop Misra (Fortis Hospitals, New Delhi, India) in an accompanying editorial [4]. “We now know from DPP and DPPOS that an intensive lifestyle intervention is effective over 10 years, and remains the best bet for prevention of diabetes. Further, during DPPOS, metformin did as well as an intensive lifestyle intervention, which might be due to the addition of the lifestyle intervention to the drug group,” he speculates. “Finally, some weight loss could be sustained over the 10 years of the lifestyle intervention and metformin, although during DPPOS, the loss of weight was not as impressive as that during DPP.”
That’s all good news, but the limitations are also succinctly put:
Knowler offered a caution about the DPP/DPPOS findings. “I consider this lifestyle intervention an important step in the right direction, but it’s clearly not sufficient. Because still, after 10 years, half the people developed diabetes. We’ve cut that rate, but obviously there’s much more to do.”
More Information
You can peruse my previous posts on diabetes. Also, check out the diabetes food pyramid below.
I think the best way I heard it described, Richard, was this: "You can pay now or you can pay later, but eventually you're going to have to pay the price." This was in connection to daily exercise…the day I'd heard it I internalized it, and been following-through ever since. 😉 But how do people in Beijing get into the whole exercise thing given the air quality? I know they do it indoors, but is that even safe?
(Adam, sorry I didn’t see this message until today!) Good for you if you exercise, you’re way ahead of me! You make a great point; no matter what, the benefits of exercise, even outdoors on good days, far outweigh the benefits of NOT exercising. I don’t want to scare people off from biking, soccoer, hiking etc. What I do want is for people to respect that outdoors can be bad sometimes and there may be days they should be more prepared. Indoor gyms are great as well, and usually the air is better of course. Yes, there are indoor pollutants and gases, but (personal opinion) most gyms have good ventilation.