https://diabetes.acponline.org/archives/2013/11/08/10.htm

Spotlight on lifestyle change

The effects of lifestyle interventions on patients with diabetes were analyzed by several recent studies.


The effects of lifestyle interventions on patients with diabetes were analyzed by several recent studies.

A meta-analysis in the Oct. 15 Annals of Internal Medicine looked at 9 randomized, controlled trials of lifestyle interventions (exercise, diet and at least 1 other component) in patients at risk for diabetes and 11 trials that included patients with diabetes. Overall, the interventions decreased the incidence of diabetes in at-risk patients, but for patients who already had the disease, researchers found no reduced risk of mortality and insufficient data to show any cardiovascular benefit. The finding of benefit from preventive interventions is encouraging, but the lack of effect on diabetic patients is of unclear clinical significance, the authors said.

In contrast, a large cohort analysis of more than 6,000 diabetics and 250,000 nondiabetics, published in the October Diabetologia, found similar benefits from following a healthy lifestyle in both groups, with patients with diabetes seeing a slightly greater benefit from healthy eating. The researchers looked at the impact of body mass index, waist/height ratio, food groups eaten, alcohol, physical activity and smoking on mortality. The diabetics and nondiabetics saw similar benefits from healthy choices, except that diabetics saw more reduction in their mortality risk from eating fruit, legumes, nuts, seeds, pasta, poultry and vegetable oil (and more increase in mortality from consuming butter and margarine). The results support recommending the same lifestyle advice to patients with and without diabetes, the authors concluded.

Another analysis, published by Diabetic Medicine Oct. 21, looked at how much newly diagnosed diabetes patients improved their diets. The 736 British patients had their diets, plasma vitamin C levels and cardiovascular disease risk assessed at baseline and 1 year. The patients reported significant reductions in energy, fat and sodium intake and increases in fruit, vegetable and fiber intake over the year. Patients whose reports of fruit intake were supported by a higher plasma vitamin C level had reductions in cardiovascular risk factors, while those who reduced fat, calorie and sodium intake also had improved hemoglobin A1c, waist circumference and cholesterol levels, even after researchers controlled for physical activity and medication changes. The authors concluded that dietary change may help reduce cardiovascular risk in newly diagnosed patients.