In a study from the German Center for Diabetes Research, scientists found intensive lifestyle intervention with plenty of exercises helps people with prediabetes improve their blood glucose levels over a period of years and thus delay or even prevent type 2 diabetes.
In particular, individuals with prediabetes at the highest risk benefited from intensive lifestyle intervention.
More exercise and healthy eating behavior help many people with prediabetes to normalize their blood glucose levels and avoid developing type 2 diabetes.
However, not everyone benefits from a conventional lifestyle intervention (LI). Recent studies show that already in prediabetes, there are different subtypes with different risk profiles.
In the study, the team examined whether people with prediabetes and a high risk benefit from an intensification of the intervention and how people with low risk are affected by a conventional LI compared to no lifestyle changes.
The intervention lasted 12 months in each case and the follow-up period was a further two years. A total of 1,105 individuals with prediabetes were investigated at various study sites.
People at high risk—these individuals produce too little insulin or suffer from the fatty liver with insulin resistance—were assigned to receive conventional LI or a more intensive intervention with double the amount of required exercise.
The team showed that more exercise, i.e. more intensive LI, helps people at high risk improve their blood glucose and cardiometabolic levels and reduce the liver fat content to within the normal range. Conventional LI is less effective.
Low-risk participants completed a conventional LI or took part in a control group that received only a one-time brief consultation.
There were hardly any differences in insulin sensitivity and secretion, liver fat content, and cardiometabolic risk.
The team says the study results showed that an individualized LI based on the risk phenotype is beneficial for diabetes prevention.
For successful prevention, scientists need to identify high-risk patients in the future and focus on providing them with an intensified lifestyle intervention.
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The study was conducted by Hans-Ulrich Häring et al and published in the journal Diabetes.
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