Featured Research

from universities, journals, and other organizations

People with pre-diabetes who drop substantial weight may ward off type 2 diabetes

Date:
July 16, 2013
Source:
Johns Hopkins Medicine
Summary:
People with pre-diabetes who lose roughly 10 percent of their body weight within six months of diagnosis dramatically reduce their risk of developing type 2 diabetes over the next three years, according to new research.

People with pre-diabetes who lose roughly 10 percent of their body weight within six months of diagnosis dramatically reduce their risk of developing type 2 diabetes over the next three years, according to results of research led by Johns Hopkins scientists.

Related Articles


The findings, investigators say, offer patients and physicians a guide to how short-term behavior change may affect long-term health.

"We have known for some time that the greater the weight loss, the lower your risk of diabetes," says 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."

Preventing pre-diabetes from becoming full-blown diabetes is critical, Maruthur says. Uncontrolled diabetes -- marked by excess sugar in the blood -- can lead to eye, kidney and nerve damage, as well as cardiovascular disease. The new research suggests that if people with pre-diabetes don't lose enough weight in those first months, physicians may want to consider more aggressive treatment, such as adding a medication to push blood sugar levels lower.

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

Maruthur and her colleagues based their conclusions on analysis of data from the Diabetes Prevention Program (DPP), the largest diabetes prevention study in the United States. Overweight, hyperglycemic people were recruited between 1996 and 1999 and followed for an average of 3.2 years. More than 3,000 participants at 27 academic medical centers were assigned at random either to receive an intense lifestyle intervention, doses of the diabetes drug metformin designed to reduce blood glucose (sugar) levels, or a placebo. Maruthur and her colleagues searched the study information for links among short-term weight loss, reduction of blood glucose levels and impact on the longer-term risk of developing diabetes.

Patients with pre-diabetes have blood sugar levels higher than normal but not yet high enough to be classified as type 2 diabetes. Although not all people with pre-diabetes develop full-blown type 2 disease, without intervention the risk of getting it within 10 years is substantially increased and damage to health may already have begun. The good news, Maruthur says, is that studies like hers show that the progression from pre-diabetes to type 2 diabetes is not inevitable and lifestyle changes can bring blood sugar levels back to normal.

Participants in the lifestyle arm of the DPP were advised about better eating habits, directed to exercise 150 minutes a week, and given one-on-one counseling for the first six months and group counseling thereafter. Researchers found that those in the lifestyle intervention arm who lost 10 percent or more of their body weight had an 85 percent reduction in risk of developing diabetes within three years. Even more moderate weight loss showed positive effects. Those who lost 5 to 7 percent of their body weight reduced their risk of developing diabetes by 54 percent three years later.

Those who were given metformin, a drug that prevents the liver from producing too much glucose, did not lose significant amounts of weight on average. But those whose blood sugar levels were significantly lowered in six months of taking the medication saw their future risk of developing diabetes fall as well.

The lowest risk, Maruthur says, occurred in patients who lost weight and also lowered the amount of glucose in their blood, as measured by a blood test taken after fasting.

"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," she says.

Maruthur says few doctors use metformin in patients with pre-diabetes, but given what her new study shows, it might make sense for them to consider prescribing the drug to patients who are unable or unwilling to lose substantial weight in the short term.

When blood tests indicate pre-diabetes, doctors like Maruthur often discuss with their patients the changes they can make to hopefully stave off type 2 diabetes. "Right now, the doctor and patient discuss this and may not discuss it again until the next appointment, which may be six months away or even longer," she says. "This routine isn't getting us anywhere."

She says doctors don't effectively provide behavior modification programs, in part because insurance rarely covers them. The new research suggests just how valuable -- and potentially cost-effective -- such interventions could be, she says.

Maruthur's work is supported by a grant from the National Institutes of Health's National Center for Research Resources (1KL2RR025006-01).

Other Johns Hopkins researchers involved in the study include Frederick L. Brancati, M.D., M.H.S., and Jeanne M. Clark, M.D., M.P.H.


Story Source:

The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Nisa M. Maruthur, Yong Ma, Linda M. Delahanty, Julie A. Nelson, Vanita Aroda, Neil H. White, David Marrero, Frederick L. Brancati, Jeanne M. Clark. Early Response to Preventive Strategies in the Diabetes Prevention Program. Journal of General Internal Medicine, 2013; DOI: 10.1007/s11606-013-2548-4

Cite This Page:

Johns Hopkins Medicine. "People with pre-diabetes who drop substantial weight may ward off type 2 diabetes." ScienceDaily. ScienceDaily, 16 July 2013. <www.sciencedaily.com/releases/2013/07/130716131909.htm>.
Johns Hopkins Medicine. (2013, July 16). People with pre-diabetes who drop substantial weight may ward off type 2 diabetes. ScienceDaily. Retrieved October 31, 2014 from www.sciencedaily.com/releases/2013/07/130716131909.htm
Johns Hopkins Medicine. "People with pre-diabetes who drop substantial weight may ward off type 2 diabetes." ScienceDaily. www.sciencedaily.com/releases/2013/07/130716131909.htm (accessed October 31, 2014).

Share This



More Health & Medicine News

Friday, October 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Melafind: Spotting Melanoma Without a Biopsy

Melafind: Spotting Melanoma Without a Biopsy

Ivanhoe (Oct. 31, 2014) The MelaFind device is a pain-free way to check suspicious moles for melanoma, without the need for a biopsy. Video provided by Ivanhoe
Powered by NewsLook.com
Battling Multiple Myeloma

Battling Multiple Myeloma

Ivanhoe (Oct. 31, 2014) The answer isn’t always found in new drugs – repurposing an ‘old’ drug that could mean better multiple myeloma treatment, and hope. Video provided by Ivanhoe
Powered by NewsLook.com
Chronic Inflammation and Prostate Cancer

Chronic Inflammation and Prostate Cancer

Ivanhoe (Oct. 31, 2014) New information that is linking chronic inflammation in the prostate and prostate cancer, which may help doctors and patients prevent cancer in the future. Video provided by Ivanhoe
Powered by NewsLook.com
Sickle Cell: Stopping Kids’ Silent Strokes

Sickle Cell: Stopping Kids’ Silent Strokes

Ivanhoe (Oct. 31, 2014) Blood transfusions are proving crucial to young sickle cell patients by helping prevent strokes, even when there is no outward sign of brain injury. Video provided by Ivanhoe
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins