Researchers at the Rollins School of Public Health at Emory University recently examined the real-world impact of lifestyle modification (LSM) on diabetes prevention in a meta-analysis published in Diabetes Care.  

The researchers pooled data from 17,272 participants from 63 heterogeneous diabetes prevention studies published between 1990 and 2015 and found that participants receiving an LSM intervention had a 29 percent lower risk of developing diabetes and lost an average of 1.5 kg (about 3.3 pounds) more body weight than those not receiving an intervention. 

"What this shows is, after considering the limitations of the studies, LSM interventions delivered under real-world conditions do have the potential to prevent or delay diabetes onset globally," says Karla Galaviz, PhD, MSc, lead author on the paper. "Two promising strategies we identified are community-based group education offered by community members or by health professionals." The LSM strategies tested in the pooled studies focused largely around improving diet and physical activity for weight loss. 

The meta-analysis also examines the role weight loss plays in minimizing diabetes risk. Researchers found that every additional kilo participants receiving an intervention lost associated with 43 percent lower odds of developing diabetes. This suggests even a small weight loss of one percent from initial weight can have an impact on diabetes risk reduction. This raises questions about current diabetes prevention reimbursement policies, such as Medicare’s, that are based on participants losing five percent of their initial weight. 

The study also revealed a discrepancy between the places where the largest burden of diabetes exists and the places where diabetes prevention efforts are concentrated. "Low- and middle-income countries bear the greatest diabetes burden and mortality, yet over 90 percent of the diabetes prevention studies we identified were implemented in high-income countries," says Galaviz. "We may be missing an opportunity to make a difference where it is needed the most." 

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