Diabetes Prevention Program
Major Clinical Trial
The Answer is Yes

Diabetes Prevention Program

The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or professional supplementation could prevent or delay the onset of type 2 diabetes in people with impaired glucose tolerance (IGT).

The answer is yes. In fact, the DPP found that over the 3 years of the study, diet and exercise sharply reduced the chances that a person with IGT would develop diabetes. Also professional supplementation reduced risk, although less dramatically. The DPP resolved these questions so quickly that, on the advice of an external monitoring board, the program was halted a year early. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine.

Diabetes Prevention Program - Study Design and Goals

In the DPP, participants from 27 clinical centers around the country were randomly selected and but into the treatment group. The group, called the lifestyle intervention group, received intensive training in diet, exercise, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7 percent of their body weight and maintain that loss.

Type 2 Diabetes and Pre-Diabetes

Diabetes is a disorder that affects the way your body uses digested food for growth and energy. Normally, the food you eat is broken down into glucose. The glucose then passes into your bloodstream, where it is used by your cells for growth and energy. For glucose to reach your cells, however, insulin must be present. Insulin is a hormone produced by your pancreas, a hand-sized gland behind your stomach.

Most people with type 2 diabetes have two problems: the pancreas may not produce enough insulin, and fat, muscle, and liver cells cannot use it effectively. This means that glucose builds up in the blood, overflows into the urine, and passes out of the body—without fulfilling its role as the body's main source of fuel.

About 20.8 million people in the United States have diabetes. Of those, 14.6 million are diagnosed and 6.2 million are undiagnosed. Ninety to 95 percent of people with diabetes have type 2 diabetes. Diabetes is the main cause of kidney failure, limb amputation, and new-onset blindness in American adults. People with diabetes are also two to four times more likely than people without diabetes to develop heart disease.

Pre-diabetes, also called impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), is a condition in which your blood glucose (blood sugar) levels are higher than normal but not high enough for a diagnosis of diabetes. Having pre-diabetes puts you at higher risk for developing type 2 diabetes. If you have pre-diabetes, you are also at increased risk for developing heart disease.

You are more likely to develop type 2 diabetes if

you are overweight
you are 45 years old or older
you have a parent, brother, or sister with diabetes
your family background is African American, American Indian, Asian American, Hispanic American/Latino, or Pacific Islander
your blood pressure is 140/90 or higher, or you have been told that you have high blood pressure
your HDL cholesterol is 35 or lower, or your triglyceride level is 250 or higher
you are fairly inactive, or you exercise fewer than three times a week

Pre-diabetes is becoming more common in the United States, according to new estimates provided by the U.S. Department of Health and Human Services. About 40 percent of U.S. adults ages 40 to 74—or 41 million people—had pre-diabetes in 2000. New data suggest that at least 54 million U.S. adults had pre-diabetes in 2002. Those with pre-diabetes are likely to develop type 2 diabetes within 10 years, unless they take steps to prevent or delay diabetes. The results of the Diabetes Prevention Program showed that modest weight loss and regular exercise can prevent or delay type 2 diabetes.

Diabetes Prevention Program Results

The DPP's striking results tell us that millions of high-risk people can use diet, exercise, and behavior modification to avoid developing type 2 diabetes. The DPP also suggests that professional supplementation is effective in delaying the onset of diabetes.

Participants in the lifestyle intervention group—those receiving intensive counseling on effective diet, exercise, and behavior modification—reduced their risk of developing diabetes by 58 percent. This finding was true across all participating ethnic groups and for both men and women. Lifestyle changes worked particularly well for participants aged 60 and older, reducing their risk by 71 percent. About 5 percent of the lifestyle intervention group developed diabetes each year during the study period, compared with 11 percent in those who did not get the intervention. Researchers think that weight loss—achieved through better eating habits and exercise—reduces the risk of diabetes by improving the ability of the body to use insulin and process glucose.

Diabetes Prevention Program
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