Pre-diabetics who drop substantial weight can avoid type 2 diabetes

People with pre-diabetes who shed a significant amount of weight shortly after diagnosis may be able to completely avoid developing type 2 diabetes later on, according to new research.

A 10 percent reduction of body weight within six months of a pre-diabetes diagnosis could be enough to ward off the complications of things like kidney failure, cardiovascular disease and nerve damage.

Progression to type 2 not inevitable

Researchers at Johns Hopkins University School of Medicine based their conclusions on data from the Diabetes Prevention Program (DDP). Patients were recruited between 1996 and 1999, and they were followed for an average of three years. Some received an intensive lifestyle intervention, some received diabetes drug metformin and some received a placebo.

Results showed that participants in the lifestyle intervention program who lost 10 percent or more of their body weight had an 85 percent reduced risk of developing diabetes within three years. And even those who lost only 5 to 7 percent of body weight had reduced their risk of developing the disease by 54 percent.

Based on the outcomes, researchers point out that the progression from pre-diabetes to type 2 diabetes is not inevitable – but steps must be taken early to prevent risk.

"We have known for some time that the greater the weight loss, the lower your risk of diabetes," said study leader Nisa Maruthur, M.D., M.H.S., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "Now we understand that we can see much of the benefit of losing that weight in those first six months when people are adjusting to a new way to eating and exercising. Substantial weight loss in the short term clearly should go a long way toward preventing diabetes."

Best results combine weight loss and blood sugar control

Patients who showed the lowest risk for developing diabetes were the ones who had not only lost a significant amount of weight, but who had also taken steps to lower blood glucose levels.

"I'm usually thrilled if a patient loses 3 to 5 percent of his or her body weight after six months, but based on this new knowledge, if patients aren't losing more weight and if their glucose remains elevated, it might be time to escalate treatment by prescribing metformin," Maruther said.

Now that the American Medical association has classified obesity as a disease, doctors will be more apt to recommend lifestyle intervention programs to diabetics – which will be "valuable" and potentially cost-effective in the long run, Maruther noted.

A report on the research is published in the Journal of General Internal Medicine.

Source: Johns Hopkins Medicine

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