Lifestyle intervention cuts diabetes risk by half in Asian Indians with prediabetes
A lifestyle intervention programme aimed at reducing intake of fat and calories appears to be effective for preventing the development of diabetes in high-risk Asian Indians, according to data from the Diabetes Community Lifestyle Improvement Program (D-CLIP) trial.
The findings suggest that a 6-month lifestyle intervention involving education and support can significantly reduce total energy intake while increasing intakes of fruits and vegetables, researchers said.
“Those in the intervention group were half as likely to develop diabetes as those in the control group at 1 year. As much as 12 percent of the risk reduction was attributable to changes in fruit and vegetable intake,” they added.
The current analysis involved 485 overweight or obese Asian Indian adults (20–65 years) with prediabetes. Of these, 240 were randomly assigned to receive standard treatment (control) and 245 to undergo the 6-month intervention to reduce intakes of fat and total calories. All participants completed a food frequency questionnaire to capture usual dietary intake.
Participants consumed an average of 2,971 kcal/day at baseline, 27.7 percent of which was from dietary fats and 60.9 percent from carbohydrates. Diabetes occurred in 49 participants over 437 person-years, with the proportion being greater in the control group than in the intervention group (151.7 vs 214.5 cases/1,000 person-years).
At 6 months, the intervention led to a substantial reduction in total energy intake (−185.6 kcal/day) and refined cereals (−7.2 g/1,000 kcal), as well as a significant increase in fruits and vegetable consumption (33.4 g/1,000 kcal). [Acta Diabetol 2019;56:197-209]
Cox analysis revealed that the lifestyle intervention cut the risk of developing diabetes at 1 year by half (hazard ratio [HR], 0.49; 95 percent CI, 0.25–0.94), with the hazard significantly attenuated following adjustment for fruits and vegetable intake (12.2 percent; p=0.015).
Despite the presence of several study limitations, the present data are consistent with previous reports and provide compelling evidence that a lifestyle intervention programme not only encourages individuals to make changes to their diet, but that these changes may be in part responsible for reducing their diabetes risk, researchers said.
D-CLIP was a randomized, controlled translational research study evaluating expert advice for diabetes prevention and proven lifestyle education curriculum (eg, the US Diabetes Prevention Program) plus metformin when needed.