[OG Note: About once or twice a year I have a "glycolated hemoglobin" test. This blood analysis reveals, like a score card, the level of blood sugar over a three to four month period. It's a better indicator of diabetes control than a regular blood test, which reveals only the control over the last day or two. This last test came back like the others-- "same as a nondiabetic," according to my doctor. So even though the Animal Control incident knocked me off base for a few weeks, I've got the cotrol back. Yesterday I went to two metformin tabs/day (down from 3) and will be going to 1/2 tab/day in a few weeks--which is where I was before. Metformin, mentioned below, is the serious name for Glucophage.]

Ariz Repub

Study finds basic lifestyle changes halve risk of adult diabetes

Los Angeles Times Aug. 08, 2001

People at high risk for developing type 2 diabetes can dramatically lower their risk of getting the disease by changing their lifestyles - even more than by taking a common diabetes drug, according to the results of a large clinical trial announced today.

The $174-million government- and industry-funded study tracked more than 3,000 diabetes-prone men and women of various ethnic backgrounds for three years. It compared the effects of a diabetes drug called metformin to that of regular exercise and changes to their diet.

The study found that the participants who made certain lifestyle changes could reduce their risk of developing the disease by 58 percent. They achieved this through an average of 30 minutes of daily exercise, lowering the fat in their diet and losing 5 to 7 percent of their body weight.

Those who took the drug but didn't have an intensive lifestyle intervention reduced their risk by 31 percent.

"In view of the rapidly rising rates of obesity and diabetes in America, this news couldn't come at a better time," said Tommy Thompson, the secretary of the Department of Health and Human Services, in announcing the findings Wednesday.

The results were so impressive that the trial ended a year earlier than was scheduled so that all patients could benefit from the findings.

The results were hailed by diabetes experts.

"It's a very important and landmark study," said Dr. William Crowley, a professor of medicine at Harvard Medical School and president of the Endocrine Society, the world's largest professional society for hormone specialists.

The study is particularly important because of its size and the fact that it took place in the United States, experts said. Smaller studies in Finland and China have showed that lifestyles could help prevent diabetes - but it wasn't clear that these findings would hold for this country's ethnically diverse population.

In the study released Wednesday, 45 percent of the participants were from minority groups with especially high rates of diabetes, such as blacks, Latinos and Asian-Americans. The lifestyle changes helped all these groups, the study found, as well as both genders and older people.

The study is also encouraging because it shows even modest changes in lifestyle can produce dramatic results.

"This is feasible - everybody could do it," said Dr. Mohammed Saad, professor of medicine at the University of California, Los Angeles, and principal investigator at one of the 27 study sites. "You don't have to go jogging or lift weights or do lots of heavy exercise. Just change your diet, lose 10 pounds, keep your weight off and walk half an hour every day."

Patients will, however, need more than occasional reminders to achieve even these modest goals, Saad said. They will need consultations with dieticians and exercise specialists and frequent followup by health care providers.

More than 16 million people in the United States have diabetes, and 95 percent of those suffer from type 2, or adult-onset, diabetes. In this case, the body loses its ability to properly regulate levels of glucose in the blood with the hormone insulin. The result, over time, can be serious side effects - such as blindness, kidney failure, nerve damage, heart disease and stroke.

"If you prevent diabetes you can prevent all these (related) problems," Saad said.

But diabetes is on the rise, including among younger people, largely due to spiraling rates of obesity in the U.S. population - caused by sedentary lifestyles and poor diet.

The 3,234 participants in the study, ages 25 to 85, were all overweight and had "impaired glucose tolerance" - abnormally high blood levels of glucose. This condition affects about 20 million people in the United States and is a precursor to diabetes. Each year, as many as 10 percent of people with impaired glucose tolerance develop full-blown diabetes.

Participants in the study were randomly divided into groups. In one, people were encouraged to make lifestyle changes. They took classes for 24 weeks and were closely monitored in various ways in the months that followed. They were also invited to participate in activities such as competitions and group walking events. The aim was a 7 percent drop in weight and 150 minutes of exercise weekly.

Another group was given the drug metformin, which was approved to treat type 2 diabetes in 1995, to see whether it could also prevent diabetes. A third group was given a placebo. Both of the latter groups were given general advice about weight loss and exercise.

After an average of three years, 29 percent of the group getting placebo had developed type 2 diabetes. Only 14 percent of the lifestyle intervention participants and 22 percent of the group taking metformin had done so.

-- Anonymous, August 09, 2001