LIFESTYLE MODIFICATIONS
Randomized controlled trials have shown that individuals at high risk for developing
type 2 diabetes (IFG, IGT, or both) can significantly decrease the rate of diabetes
onset with particular interventions (1–5). These include intensive lifestyle modification programs that have been shown to be very effective (;58% reduction after 3
years). Follow-up of all three large studies of lifestyle intervention has shown sustained reduction in the rate of conversion to type 2 diabetes: 43% reduction at 20
years in the Da Qing study (6), 43% reduction at 7 years in the Finnish Diabetes
Prevention Study (DPS) (7), and 34% reduction at 10 years in the U.S. Diabetes Prevention Program Outcomes Study (DPPOS) (8). A cost-effectiveness model suggestedthat lifestyle interventions in the Diabetes Prevention Program (DPP) are cost-effective (9). Actual cost data from the DPP and DPPOS confirm that the lifestyle interventions are highly cost-effective (10). Group delivery of the DPP intervention in community settings has the potential to be significantly less expensive while still achieving similar weightloss(11).The Centers for Disease Controland Prevention (CDC) helpscoordinate the National Diabetes Prevention Program, a resource designed to bring evidencebased lifestyle change programs for preventing type 2 diabetes to communities
(http://www.cdc.gov/diabetes/prevention/index.htm).
Given the clinical trial results and the knownrisks of progressionof prediabetesto
diabetes, people with an A1C 5.7–6.4%, IGT, or IFG should be counseled on lifestyle
changes with goals similar to those of the DPP (7% weight loss and moderate-
intensity physical activity of at least 150 min/week)
LIFESTYLE MODIFICATIONS
Randomized controlled trials have shown that individuals at high risk for developing
type 2 diabetes (IFG, IGT, or both) can significantly decrease the rate of diabetes
onset with particular interventions (1–5). These include intensive lifestyle modification programs that have been shown to be very effective (;58% reduction after 3
years). Follow-up of all three large studies of lifestyle intervention has shown sustained reduction in the rate of conversion to type 2 diabetes: 43% reduction at 20
years in the Da Qing study (6), 43% reduction at 7 years in the Finnish Diabetes
Prevention Study (DPS) (7), and 34% reduction at 10 years in the U.S. Diabetes Prevention Program Outcomes Study (DPPOS) (8). A cost-effectiveness model suggestedthat lifestyle interventions in the Diabetes Prevention Program (DPP) are cost-effective (9). Actual cost data from the DPP and DPPOS confirm that the lifestyle interventions are highly cost-effective (10). Group delivery of the DPP intervention in community settings has the potential to be significantly less expensive while still achieving similar weightloss(11).The Centers for Disease Controland Prevention (CDC) helpscoordinate the National Diabetes Prevention Program, a resource designed to bring evidencebased lifestyle change programs for preventing type 2 diabetes to communities
(http://www.cdc.gov/diabetes/prevention/index.htm).
Given the clinical trial results and the knownrisks of progressionof prediabetesto
diabetes, people with an A1C 5.7–6.4%, IGT, or IFG should be counseled on lifestyle
changes with goals similar to those of the DPP (7% weight loss and moderate-
intensity physical activity of at least 150 min/week)
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