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A healthy diet helps fight the spread of type 2 diabetes. Photo: Istock/LD
A lifestyle intervention program of increasing physical activity, eating healthy, and trying to lose 7 percent or more weight, or taking the medication metformin, are effective at long-term to delay or prevent type 2 diabetes in adults with prediabetes.
However, neither approach reduced participants’ cardiovascular disease risk over the 21-year duration of the multicenter Diabetes Prevention Program Outcomes Study (DPPOS). ), the results of which were published this Monday in the journal Circulation, edited by the American Heart Association (AHA).
Type 2 diabetes (T2D) is the most common form of diabetes, and cardiovascular disease (CVD) is the leading cause of death and disability among people with T2D. Type 2 diabetes occurs when the body is unable to effectively use the insulin it makes and the pancreas is unable to produce sufficient amounts of insulin.
Adults with T2D are twice as likely to die from CVD (including heart attack, stroke, or heart failure) compared to those without T2D. People with T2D often have other risk factors for cardiovascular disease, such as being overweight or obese, high blood pressure, or high cholesterol.
Study participants were selected and accepted based on these criteria : Initially, a 2-hour glucose reading of 140-199 mg/dL on an oral glucose tolerance test; fasting glucose levels of 95-125 mg/dL; and a body mass index of 24 kg/m2 or higher.
A racially diverse group of 3,234 adults was studied in the original DPP for nearly three years. The mean age of the participants was 51, and nearly 70 percent were women. People in the intensive lifestyle intervention group (nutritional improvement and physical activity with a goal of 7% weight loss) reduced the incidence of developing T2D by 58 percent, and participants who took twice-daily doses of metformin had a 31 percent reduced incidence of T2D, compared with people in the placebo group who received standard care, which included information n on effective treatment and management of T2D at diagnosis.
The DPPOS began in 2002 and was open to all participants in the original DPP trial. The DPPOS included Nearly 90 percent of the original study participants were followed up for 25 years to assess the long-term impact of interventions on the development of T2D and its complications.
Due to the success After the lifestyle intervention, all study participants were offered Enroll in lifestyle intervention in a group format during a one-year bridging period.
The group that took metformin in the original DPP trial were able to continue taking the medication during the DPPOS, and were aware that they were taking metformin and not the placebo. cardiovascular disease outcomes to determine the effects of lifestyle interventions and metformin on participants’ risk of nonfatal myocardial infarction, stroke, or death due to a cardiovascular event , comparing the results of each intervention group with the placebo group.
Throughout the study, participants were examined annually with electrocardiogram tests; measures of your risk factors for cardiovascular disease, including smoking, cholesterol levels, and blood pressure levels; and body mass index measurements.
After a median of 21 years of follow-up, the investigators found no significant difference in the incidence of myocardial infarction, stroke, or cardiovascular death among the three intervention groups.
Specifically, the analysis lysis discovered There was a continued reduction or delay in the development of T2D for up to 15 years. The number of nonfatal heart attacks in each group was similar: 35 heart attacks in the lifestyle intervention group, 46 in the metformin group, and 43 in the placebo group. /p>
Similarities were also found in the number of non-fatal strokes: 39 stroke incidences in the lifestyle intervention group; 16 in the metformin-only group; and 28 in the placebo group.
The number of deaths from cardiovascular causes was low: 37 deaths among lifestyle intervention participants; 39 in the metformin group; and 27 in participants who took placebo during the original DPP trial.
“The fact that neither the lifestyle intervention program nor metformin produced a decrease in Increased cardiovascular disease among people with prediabetes may mean that these interventions have limited or no efficacy in preventing cardiovascular disease, although they are highly effective in preventing or delaying the development of type 2 diabetes,” the researchers explain. .