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 modifi-
cation 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 suggested
that 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
weight loss (11). The Centers for Disease Control and Prevention (CDC) helps coordinate
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).