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Lifestyle Counseling May Have Lasting Benefits for People at High Risk for Diabetes By Miranda Hitti

Nov. 10, 2006 -- People at high risk for type 2 diabetes may reap long-lasting benefits from lifestyle counseling – benefits that continue years after the counseling ends.

That's according to a Finnish study published in this month's The Lancet.

Researchers included Jaana Lindstrom, MSc, of Finland's National Public Health Institute.

They note markedly lower diabetes rates over seven years in high-risk people who got counseling on weight, diet, and exercise for four years, compared with those who didn't get counseling.

The counseled patients were 43% less likely to develop diabetes during the study than those in a comparison group receiving no counseling.

"A simple lifestyle intervention seems to work well," write Lindstrom and colleagues.

The key seems to be making a lasting change and losing at least some excess weight, notes a journal editorial.

Lifestyle Makeover

Lindstrom's team studied 522 overweight, middle-aged Finnish men and women with impaired glucose (blood sugar) tolerance, a warning sign of diabetes risk. Impaired glucose tolerance is abnormally elevated blood sugars -- but not in the range needed to diagnose diabetes.

The researchers randomly split the patients into two groups.

One group got personalized lifestyle counseling to help them meet the following goals:
Lose at least 5% of body weight.
Cut dietary fat to 30% or less of daily calories.
Cut saturated fat to 10% or less of dietary fat.
Eat at least 15 grams of dietary fiber per 1,000 calories.
Get 30 minutes or more of daily moderate-intensity physical activity.

For an average of four years, the counseled patients got free, supervised exercise sessions and regularly met with a nutritionist to work on their diets.

Patients in the comparison group got general information about lifestyle changes but didn't receive any counseling.

Diabetes Rarer in Counseled Group

The researchers tracked the patients' progress for an average of seven years -- three years longer than the average counseling period.

The counseled patients were, overall, 43% less likely to develop diabetes. Even after the counseling sessions ended, the counseled patients were 36% less likely to get diabetes than those in the comparison group.

"Our results confirm the findings from earlier studies showing that interventions can have long-term effect on lifestyle," the researchers write.

They note that weight loss seemed to be the most important factor in preventing diabetes.

More studies are needed to see how intensive the lifestyle change must be in order to prevent diabetes, writes editorialist Ronald Goldberg, MD, of the University of Miami's Diabetes Research Institute.

SOURCES: Lindstrom, J. The Lancet, Nov. 11, 2006; vol 368: pp 1673-1679. Goldberg, R. The Lancet, vol 368: pp 1635-1636. News release, The Lancet.