by Michael Woodhead  

Follow up of one of the largest ever type-2 diabetes prevention trials shows that lifestyle interventions focused on weight loss have benefits that persist for at least a decade.  

The onset of diabetes was delayed by up to four years in patients who took part in the Diabetes Prevention Program (DPP) trial that started in the 1990s, say US researchers in the Lancet (374:1677) today.  

In the initial study, patients at risk of diabetes showed about 7kg weight loss in response to an intensive  lifestyle regimen, and this proved to be more effective at diabetes prevention over a three year period than metformin.  

Now in a ten year follow up of more than 3000 patients, the researchers found that although the lifestyle group regained some of the weight they lost, they still showed a 34% lower diabetes incidence than a placebo group.

Patients from the original metformin prevention group showed a 18% reduction in diabetes incidence, though some of the reduction may have been attributable to less rigorous lifestyle interventions they received after the end of the original trial, say the study authors.  

“In this study, onset of diabetes was delayed by about four years by lifestyle intervention and two years by metformin,” they conclude.  

A reduction in diabetes cumulative incidence by either lifestyle intervention or metformin therapy persists for at least 10 years,” they add.  

An accompanying editorial say the findings confirm that intensive lifestyle interventions are “the best bet” for diabetes prevention, but there are no short cuts, and more research is needed on the best physical activity and dietary interventions to prevent diabetes.