Exercise, Diet, Metformin Can Keep Diabetes at Bay for 10 Years

Nov. 1, 2009— -- Diet, exercise and, to a lesser extent, an inexpensive drug can help keep Type 2 diabetes at bay for up to 10 years, researchers said.

In a new study, individuals at risk of type 2 diabetes significantly reduced their chances of developing the condition by taking the diabetes drug metformin and adhering to a diet-and-exercise program, according to Dr. William C. Knowler and colleagues on the government's Diabetes Prevention Program Research Group.

Writing online in The Lancet, the researchers said people initially assigned to diet and physical activity modifications showed a 34 percent reduction in later diagnosis of type 2 diabetes during follow-up, compared to a group that took a placebo pill.

Another group assigned to metformin treatment were at 18 percent less risk for type 2 diabetes compared with the placebo group. Metformin is a popular oral drug often used as a first-line treatment for incipient Type 2 diabetes.

"Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years," Knowler and colleagues wrote.

Beginning in 1996, the original study assigned more than 3,800 people showing impaired glucose tolerance, but not full-blown diabetes, to participate in an intensive diet-and-exercise program, to receive metformin, or to receive placebo.

By 2001, the results showed a 58 percent reduction in diabetes diagnoses in the diet-and-exercise group and a 31 percent reduction in the metformin group.

In addition to diabetes incidence, the researchers also tracked body weight of the subjects in the study. What they found was that those taking the metformin lost about 2 kg (4.4 pounds) in the first year of the trial, which was maintained during the rest of the randomized phase and throughout the follow-up.

During the randomized phase, participants in the diet-and-exercise arm lost a mean of almost 7 kg (15.4 pounds) in the first year, but regained weight in the next two years, for a net loss at year three of about 4 kg (8.8 pounds). By year five, the net loss had shrunk to 2 kg (4.4 pounds), which continued to the end of follow-up.