EHS 260 Lecture Notes - Lecture 31: Intervention (Counseling), Impaired Glucose Tolerance, Metformin
18 Jun 2018
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Can lifestyle changes prevent/reduce the risk for DM?
US Diabetes Prevention Program - RCT (multi-center; n=3,234 men and women with impaired
fasting glucose and impaired glucose tolerance)
Placebo (control)
Metformin
Intensive life-style modification program
Goals: 150min/wk PA and 7% wt loss
Lifestyle intervention vs. pharmacological treatment in overweight people with impaired glucose
tolerance
Can lifestyle changes prevent/reduce the risk for DM?
Two main intervention studies demonstrating the effectiveness of lifestyle intervention for
preventing diabetes:
1) Finish Diabetes Prevention Study, and
2) US Diabetes Prevention Program
Finish Diabetes Prevention Study
N=522 men and women
Age: 40-65
Overweight and with impaired glucose control
RCT
Control (oral and written instructions)
vs.
Intervention (counseling)
Goals
Decrease wt by 5% or more
Decrease fat <30% kcals consumed
Decrease sat fat <10%kcals consumed
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Us diabetes prevention program - rct (multi-center; n=3,234 men and women with impaired fasting glucose and impaired glucose tolerance) Lifestyle intervention vs. pharmacological treatment in overweight people with impaired glucose tolerance. Two main intervention studies demonstrating the effectiveness of lifestyle intervention for preventing diabetes: finish diabetes prevention study, and, us diabetes prevention program. Fitness and risk of developing type 2 diabetes in women. Inactivity has an adverse effect on glucose tolerance. The beneficial effect of exercise on glucose tolerance is thought to be due, in part, to improvement in insulin sensitivity; glucose transport into muscle is improved, as is glycogen synthesis; improved capillarization; More mitochondria; increased activity of oxidative enzymes. Increased density and blood flow in the capillaries. Physical fitness as a risk factor for dm-2. N=8,633 non-diabetic men f/u: ~ 6 years. Compared to those in the top 2 quintiles, those with low fitness (lowest quintile) had: 1. 9 times relative risk of developing impaired fasting glucose.
