Journal ArticleDOI
Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study
Xiao Ren Pan,Guang Wei Li,Ying Hua Hu,Ji Xing Wang,Wenying Yang,Zuo Xin An,Ze Xi Hu,Juan Lin,Jian Zhong Xiao,Hui Bi Cao,Ping An Liu,Xi Gui Jiang,Ya Yan Jiang,Jin Ping Wang,Hui Zheng,Hui Zhang,Peter H. Bennett,Barbara V. Howard +17 more
TLDR
Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT, and thereby reduce the overall incidence of diabetic complications.Abstract:
OBJECTIVE Individuals with impaired glucose tolerance (IGT) have a high risk of developing NIDDM. The purpose of this study was to determine whether diet and exercise interventions in those with IGT may delay the development of NIDDM, i.e., reduce the incidence of NIDDM, and thereby reduce the overall incidence of diabetic complications, such as cardiovascular, renal, and retinal disease, and the excess mortality attributable to these complications. RESEARCH DESIGN AND METHODS In 1986, 110,660 men and women from 33 health care clinics in the city of Da Qing, China, were screened for IGT and NIDDM. Of these individuals, 577 were classified (using World Health Organization criteria) as having IGT. Subjects were randomized by clinic into a clinical trial, either to a control group or to one of three active treatment groups: diet only, exercise only, or diet plus exercise. Follow-up evaluation examinations were conducted at 2-year intervals over a 6-year period to identify subjects who developed NIDDM. Cox9s proportional hazard analysis was used to determine if the incidence of NIDDM varied by treatment assignment. RESULTS The cumulative incidence of diabetes at 6 years was 67.7% (95% CI, 59.8–75.2) in the control group compared with 43.8% (95% CI, 35.5–52.3) in the diet group, 41.1% (95% CI, 33.4–49.4) in the exercise group, and 46.0% (95% CI, 37.3–54.7) in the diet-plus-exercise group ( P P 2 ). In a proportional hazards analysis adjusted for differences in baseline BMI and fasting glucose, the diet, exercise, and diet-plus-exercise interventions were associated with 31% ( P P P CONCLUSIONS Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT.read more
Citations
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Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
William C. Knowler,Elizabeth Barrett-Connor,Sarah E. Fowler,Richard F. Hamman,John M. Lachin,Elizabeth A. Walker,David M. Nathan +6 more
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Journal ArticleDOI
Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030
TL;DR: Findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant, and given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
Journal ArticleDOI
Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance.
Jaakko Tuomilehto,Jon Lindstrom,Johan G. Eriksson,Valle Tt,Helena Hämäläinen,Pirjo Ilanne-Parikka,Keinänen-Kiukaanniemi S,Mauri Laakso,Anne Louheranta,Rastas M,Salminen,Matti Uusitupa +11 more
TL;DR: Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects by means of individualized counseling aimed at reducing weight, total intake of fat, and intake of saturated fat and increasing intake of fiber and physical activity.
Standards of Medical Care in Diabetes
TL;DR: These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care.
Journal ArticleDOI
Prevalence of the Metabolic Syndrome Among US Adults: Findings From the Third National Health and Nutrition Examination Survey
TL;DR: These results from a representative sample of US adults show that the metabolic syndrome is highly prevalent and the large numbers of US residents with the metabolic Syndrome may have important implications for the health care sector.
References
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Journal ArticleDOI
Insulin Resistance and Insulin Secretory Dysfunction as Precursors of Non-Insulin-Dependent Diabetes Mellitus: Prospective Studies of Pima Indians
Stephen Lillioja,David M. Mott,M. Spraul,R T Ferraro,James E. Foley,Eric Ravussin,William C. Knowler,Peter H. Bennett,Clifton Bogardus +8 more
TL;DR: Obesity, insulin resistance, and low acute plasma insulin response to intravenous glucose (with the degree of obesity and insulin resistance taken into account) were predictors of NIDDM.
Journal ArticleDOI
Impaired glucose tolerance as a disorder of insulin action. Longitudinal and cross-sectional studies in Pima Indians
Stephen Lillioja,David M. Mott,Barbara V. Howard,Peter H. Bennett,Hannele Yki-Järvinen,Daniel Freymond,B. L. Nyomba,Francesco Zurlo,Boyd Swinburn,Clifton Bogardus +9 more
TL;DR: The data show that impaired glucose tolerance in the study population is primarily due to impaired insulin action, and relative insulin deficiency first appears at the lower end of the second (diabetic) mode seen in population frequency distributions of plasma glucose concentrations.
Journal ArticleDOI
The Natural History of Impaired Glucose Tolerance in the Pima Indians
Mohammed F. Saad,William C. Knowler,David J. Pettitt,Robert G. Nelson,David M. Mott,Peter H. Bennett +5 more
TL;DR: It is concluded that in this population approximately one fourth of subjects with impaired glucose tolerance have NIDDM at five years and two thirds at 10 years (approximately one third revert to normal) and that age and plasma glucose and insulin levels are the best predictors of clinical outcome.
Journal ArticleDOI
Incidence of Type II Diabetes in Mexican Americans Predicted by Fasting Insulin and Glucose Levels, Obesity, and Body-Fat Distribution
TL;DR: Body mass index, ratio of subscapular-to-triceps skin fold, and fasting glucose and insulin concentrations are examined as predictors of decompensation to type II diabetes in Mexican Americans, a population at high risk for this disorder.
Journal ArticleDOI
Ten-year follow-up of subjects with impaired glucose tolerance: prevention of diabetes by tolbutamide and diet regulation.
TL;DR: It seems possible that treatment with diet regulation, in combination with tolbutamide, may prevent or postpone progression from impaired glucose tolerance to manifest diabetes.
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