Published: 11 November 2020
The largest diabetes prevention study in 30 years has found that losing just a few kilograms of weight can halve the risk of developing diabetes.
Providing support to help people with prediabetes to make small changes to their lifestyle, diet and physical activity over two years helped reduce the risk of developing type 2 diabetes by 40 to 47 per cent, the study found.
The research was funded by NIHR Programme Grants for Applied Research and was led by the Norfolk and Norwich University Hospital (NNUH) and East Anglia University, together with colleagues from Ipswich Hospital, and the Universities of Birmingham and Exeter.
There are about eight million people with prediabetes in the UK, and 4.5 million have already developed type 2 diabetes. People with family history of diabetes, or people who are overweight or inactive, are more at risk.
The Norfolk Diabetes Prevention Study (NDPS) tested a simple lifestyle intervention, involving counseling to encourage behaviour change and goal-setting, group exercise sessions and educational sessions. These focused on increasing physical activity to 2.5 hours and completing 2-3 muscle-strengthening sessions per week as well as reducing intake of saturated fats.
The intervention, guided by healthcare professionals, helped people make small achievable lifestyle changes that led to a modest weight loss (two to three kilograms) and increased their physical activity. Importantly, these changes were sustained for at least two years and the weight lost was not put back on.
These findings, published in JAMA Internal Medicine, are important as they show that a ‘real-world’ lifestyle programme really can make a difference in helping people reduce their risk of type 2 (adult onset) diabetes.
Professor Mike Sampson, NDPS Chief Investigator and Consultant in Diabetes at NNUH, said: “We are delighted with the results of this trial, as until now no one was very sure if a real-world lifestyle programme prevented type 2 diabetes in the prediabetes population we studied, as there have been no clinical trials that had shown this.”
“We have now shown a significant effect in type 2 diabetes prevention, and we can be very optimistic that even a modest weight loss, and an increase in physical activity, in real world programmes like this have a big effect on the risk of getting type 2 diabetes.”
NDPS ran between 2011 and 2018 and worked with 135 GP practices in the East of England. The researchers identified 144,000 people who were at risk of developing type 2 diabetes, and 1,000 with prediabetes were then entered into the study.
The NDPS randomised controlled trial tested a pragmatic real-world lifestyle intervention compared to a control group, with average follow-up of just over two years.
NDPS also asked lay members of the public who had type 2 diabetes themselves to act as ‘diabetes prevention mentors’ to participants with prediabetes in the trial, but for this particular population this did not further reduce the risk of getting type 2 diabetes.
Professor Mike Sampson described the importance of the results: “This is really great news for the eight million people in the UK with a prediabetes diagnosis. The results of this trial, show that diabetes prevention is possible in the same prediabetes populations being treated in the NHS national diabetes prevention programme. This is important to know, as the clinical methods for diagnosing diabetes and prediabetes have changed a lot in recent years.”
Colin Greaves, Professor of Psychology Applied to Health at University of Birmingham, who jointly led the development of the NDPS intervention, said: “If you have been diagnosed with prediabetes, this approach offers a way to take a different direction in your life – to get off the path to type 2 diabetes and onto the road to a healthier future.”
The Diabetes UK diabetes risk calculator – this allows people to estimate their own risk of Type 2 diabetes.
NHS England’s Healthier You national diabetes prevention programme, the national clinical programme to prevent Type 2 diabetes.