How Diet and Exercise Help Type 2 Diabetes

Posted: Nov. 1, 2004

Studies show that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight. You can do it by eating healthier and getting 30 minutes of physical activity five days a week. In other words, you don't have to knock yourself out to prevent diabetes.

Research found that at least 10 million Americans at high risk for type 2 diabetes can sharply lower their chances of getting the disease with diet and exercise.

The same study found that treatment with the oral diabetes drug metformin (Glucophage®) also reduces diabetes risk, though less dramatically, in people at high risk for type 2 diabetes.

Diabetes Prevention Program
The findings, announced in August 2001, came from the Diabetes Prevention Program (DPP), a major clinical trial in 3,234 people with impaired glucose tolerance, a condition that often precedes diabetes. The study compared (1) intensive lifestyle changes consisting of diet and exercise; (2) treatment with the oral diabetes drug metformin; and (3) placebo (a control group that took placebo pills in place of metformin). The second and third groups also received standard information on diet and exercise.

Most common in adults over age 40, type 2 diabetes affects 8 percent of the U.S. population age 20 and older. It is strongly associated with obesity (more than 80 percent of people with type 2 diabetes are overweight), inactivity, family history of diabetes and racial or ethnic background. Compared to Caucasians, African Americans have a 60 percent higher rate of type 2 diabetes and Hispanic adults have a 90 percent higher rate.

The prevalence of type 2 diabetes has tripled in the last 30 years, and much of the increase is due to the dramatic upsurge in obesity.

How do diet and physical activity work to prevent diabetes?
Obesity and sedentary lifestyle are known to increase the risk of both insulin resistance and type 2 diabetes. Insulin resistance, a disorder in which target tissues — muscle, fat, and liver cells — fail to use insulin effectively, accompanies and usually precedes type 2 diabetes.

With the onset of insulin resistance, the pancreas compensates by producing more insulin, but gradually its capacity to secrete insulin in response to meals falters, and the timing of insulin secretion becomes abnormal. Weight loss resulting from diet and increased physical activity may lower diabetes risk by improving the ability of muscle cells to use insulin and to handle glucose more efficiently.

Are diet and exercise beneficial even after diabetes develops?
Research has clearly shown that diet and exercise help people with type 2 diabetes control their blood glucose, blood pressure and blood lipids in the short term.

Although diet and exercise should lower the risk of developing cardiovascular disease and the other complications of diabetes, no long-term clinical trials have addressed this question. A recently launched trial, the Look AHEAD (Action for Health in Diabetes) study, will examine how diet and exercise affect heart attack, stroke and cardiovascular-related death in people with type 2 diabetes.

Sources: Center for Disease Control and Prevention and National Institute of Diabetes and Digestive and Kidney Disorders

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