Lifestyle interventions were effective in reducing the rate of diagnosis of diabetes in prediabetic adults when compared with standard treatment with medication. Researchers also noted improved control of blood sugar, improved exercise capacity, and increased weight loss with lifestyle adaptations. Nevertheless, issues with adherence to lifestyle changes caused deterioration in long-term health improvements.
George Kerrison, from the School of Health Sciences at the University of Nottingham, and colleagues reported their findings in the Journal of Diabetes Research in April 2017. The researchers critically analyzed 9 randomized controlled trials to assess blood sugar control and incidence of diabetes diagnosis following lifestyle interventions. Additionally, changes in body mass index (BMI), weight, and exercise capacity were assessed.
Each study adopted different methodologies for delivering lifestyle interventions; nevertheless, healthy eating and an increase in moderate physical activity were promoted in all 9 studies. The majority of the studies delivered interventions via face-to-face meetings; others used phone interviewing or group-based sessions. The majority of the studies followed participants for 36 months.
The incidence of diabetes diagnosis was higher in the control groups (standard treatment) than in the lifestyle intervention groups in all studies except for the only study that used group-based sessions. This indicates that an individualized approach might be more effective. Blood glucose was better controlled in the intervention groups; fewer participants remained with prediabetes at the end of the study. In the short term, lifestyle adaptations were effective in controlling blood glucose; however, long-term follow-up revealed obstacles with adherence. Physical exercise capacity was greater in the intervention group; still, the number of participants performing 150 minutes of activity per week was low. Finally, over the short term, weight and BMI were improved following lifestyle adaptations, but a lack of long-term motivation for change resulted in weight and BMI increases.
The results of this systematic review encourage lifestyle changes to prevent diabetes in prediabetic patients; however, obstacles with adherence to lifestyle modifications were apparent. Once the intensity of the interventions dropped, improvements in blood glucose control, physical exercise capacity, BMI, and weight all deteriorated.
Lifestyle adaptations were effective in preventing diabetes, controlling blood glucose, improving exercise capacity, and reducing weight and BMI. Before this intervention is used in practice, more studies are required to assess how to improve patient adherence to lifestyle adaptations.
Written by Jessica Caporuscio, PharmD