Diet and Exercise Programs Mitigate Diabetes Risk
A task force including government, academic, policy and practice-based researchers from the Centers for Disease Control and Prevention, Brown University and HealthPartners has determined that diet and exercise programs are effective in helping to prevent or control type 2 diabetes.
The Community Preventive Services Task Force (CPSTF) reached its conclusion after reviewing 53 studies that evaluated a total of 66 programs that promote diet changes and increased physical activity. Among those studies, 30 compared diet and physical activity programs against usual care, while 12 compared intensive and less intensive programs, and 13 reviewed single programs. The team found that nearly all the diet and physical activity programs reduced incidence of type 2 diabetes as well as decreasing body weight and fasting blood glucose, with more intensive programs found to be more effective.
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Based on its review—which the authors say offers “strong evidence of effectiveness” of such programs—the task force suggests combined diet and physical activity programs for individuals at increased risk of type 2 diabetes, defined by the CPSTF as those having abnormally high levels of blood glucose, but not high enough to be considered type 2 diabetic. The task force outlined a variety of elements that effective programs should include, such as trainers who work directly with participants in clinics and communities for a minimum of 3 months; counseling, coaching, and extended support; and sessions delivered in person or via email or online, or all three.
Most patients “know that eating a healthful diet and being physically active is good for them and if they have prediabetes, it will reduce their risk for diabetes diagnosis,” says Nicolaas Pronk, PhD, vice president and chief science partner at Minneapolis, Minn.-based HealthPartners, a co-author of the review and member of the task force.
“For a physician to simply tell them that, however, doesn’t really work,” says Pronk, noting that the task force recommendations are based on “the notion that a structured lifestyle program can prevent diabetes. The key here is structure.”
Primary care physicians need to be able to refer to a structured program that patients can access, he says, “so as to receive the dose of lifestyle intervention necessary to see successful results, which is not necessarily easily done.”
Furthermore, “all doctors need to be aware of the benefits that structured programs can provide and support their patients in engaging fully [in such programs].”
For this to happen, “a connection needs to be made between the clinic and the community so patients can access these programs … A system need to be created to allow that to happen, much like the pharmaceutical prescription system that uses a pill to efficiently and effectively deliver the program to the patient,” says Pronk.
“Only here, the pill is a structured lifestyle program. Programs are available in every state, such as the National Diabetes Prevention Program, and the CDC provides information about recognized programs on its website.”
Balk E, Earley A, et al. Combined Diet and Physical Activity Promotion Programs to Prevent Diabetes. Ann Intern Med. 2015.