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Wednesday, Oct. 28, 2009

Study: 10 years of diet, exercise can keep diabetes at bay

A national study on diabetes, to be published online Thursday, concludes that people who stuck to a 10-year diet and exercise plan cut their risk of developing the disease by 34 percent.

Olga Leon could be the poster child for a decade-long, nationwide study on pre-diabetic patients. At 74, she pumps iron at Don Shula's Athletic Club in Miami Lakes.

She strides the treadmill, lifts weights, does aerobics and Pilates.

She eats six eggs for breakfast -- whites only, of course -- and drinks a shake of cucumbers and water. Ten years ago, Leon was overweight and pre-diabetic with a system that was developing glucose intolerance. Her luckiest day, she says, was when she got into a national study, run in part by the University of Miami, to see if strict diet and exercise could keep her and more than 3,000 subjects like her from getting full diabetes.

It worked.

Today, Leon, who lives near Pembroke Pines, weighs in at 133 pounds, 35 pounds lighter than when she started, has great cholesterol numbers and not one trace of diabetes.

``I'm so happy,'' she said. ``Everybody in my family had diabetes -- my grandmother, my grandfather, my uncles, aunts, everybody.''

The national study -- which appears online Thursday in the peer-reviewed journal The Lancet -- concludes that people who stuck to the prescribed diet and exercise for 10 years cut their diabetes risk by 34 percent.

They also had lower blood pressure and triglyceride levels despite taking fewer drugs.

Other pre-diabetics who took a diabetes drug but didn't couple that with diet or exercise cut their risk by 18 percent.

The study began with 3,234 mostly obese and pre-diabetic subjects at 27 study sites, including 150 at the Diabetes Research Institute of the University of Miami Miller School of Medicine.

``When you consider the devastating medical complications that go with type 2 diabetes, these are very significant findings,'' said Dr. Ronald Goldberg, principal investigator of the UM arm of the study. ``It demonstrates that lifestyle changes can last as long as 10 years in preventing or slowing diabetes in people who are at risk.''

Researchers find the results so significant that they plan to extend the study -- with UM's participation -- for another five years. The National Institutes of Health has already promised funding.

ACROSS AMERICA

In the United States, about 11 percent of adults, or 24 million people, have diabetes, and 95 percent of those have type 2 diabetes.

The rate is higher, at 14.7 percent, among black people and slightly lower, at 10.4 percent, among Hispanic people, according to the American Diabetes Association.

Another 57 million overweight adults have glucose levels that are high but not yet in the diabetic range, according to the National Institutes of Health.

The study was an extension of an earlier three-year Diabetes Prevention Program study of 3,234 subjects that had reported even more dramatic results -- cutting the diabetes risk by 58 percent. The results were so dramatic that the study was concluded early so people could take advantage of the results.

When the study continued in 2002, it included 88 percent of the participants of the earlier program. Researchers wanted to see if the improvements could be maintained over time.

THE COMMITMENT

For 10 years, Leon kept up her regimen of diet and exercise. Her breakfast was cereal with soy milk, without sugar, fruits and egg whites. Lunch and dinner were chicken or fish and lots of vegetables. She snacked on carrots and celery and homemade diet shakes.

Her dress size dropped from a 40 to an eight.

``I feel so happy that the program changed my whole life. My cholesterol was very high. Now it's excellent, excellent, excellent.''

The average weight loss of the study subjects was relatively modest -- starting at about 15 pounds and dropping to about five pounds toward the end.

Exercise regimens, which started out very strict, with professional help, eased off a bit over time.

Doctors could only speculate whether the participants would have done even better if they had strictly followed the lifestyle changes.

Goldberg did say the few obese participants who lost up to 100 pounds did better than those who lost less.

And since many of the pre-diabetic subjects like Leon did not develop diabetes during the entire study period, it leaves researchers asking whether diet and exercise can prevent it altogether. They also are pondering whether some would get diabetes anyway if it ran in their families.

In the study, between 5 and 6 percent of participants per year were diagnosed with diabetes.

Because of the powerful results for pre-diabetics, researchers now want to study whether such lifestyle changes can help those already with the disease.

``The $64,000 question is whether this kind of intervention in people who already have diabetes can prevent or slow its complications -- the eye, nerve, kidney, heart and stroke complications that people with diabetes have,'' Goldberg says.