Results of the largest diabetes prevention study to date were published Feb. 7 in The New England Journal of Medicine, but researchers at The University of Texas Health Science Center at San Antonio (UTHSC) hardly were taking any time to celebrate the achievement.
They are busy recruiting 330 new participants for another 12-year study of the long-term effects of obesity and weight loss in Type 2 diabetics.
The new study, "LOOK AHEAD: Action For Health In Diabetes," will assess the role of weight loss in warding off diabetes-related cardiovascular events such as heart attack and stroke. "We have shown that if people can lose five to seven percent of their body weight, they will be protected from major diseases such as cardiovascular disease," said Maria Montez, diabetes program coordinator and faculty associate in the UTHSC department of medicine.
Participants should be 45 to 75 and have Type 2 diabetes. Interested individuals are invited to call (210) 567-4799 to be screened for eligibility.
"If a person completes the four-visit screening process and is randomized into the program, we can provide some reimbursement for travel expenses," said Montez, a registered nurse and certified diabetes educator.
Patients will be assigned to an intensive lifestyle program or a diabetes support and education group. The intensive lifestyle group will meet weekly for 16 weeks and the diabetes support group will meet quarterly. "We know that people lose weight if they are monitored very closely. If people are left on their own, even if they have information on diet and exercise, it is very difficult to adhere to a program," Montez said.
The New England Journal of Medicine article summarized results of the Diabetes Prevention Program, which included UTHSC as a primary clinical center. Steven M. Haffner, M.D., professor of medicine at UTHSC, was a national principal investigator.
UTHSCSA enrolled 200 patients from San Antonio and surrounding areas. Selection criteria included risk factors for diabetes, such as obesity and family history of diabetes. A third of the participants were placed on a drug called Metformin, a third were assigned to placebo, and a third were enrolled in an intensive lifestyle program involving dietary counseling and exercise recommendations. Lifestyle intervention reduced the incidence of diabetes by 58 percent, while Metformin alone reduced it by 31 percent. Metformin acts by improving sensitivity to insulin.
Dr. Haffner was traveling on Feb. 7, but Montez said:
"One of the things that is important about this particular study is that lifestyle intervention was effective in participants of all ages. Even in people who were 60 plus, lifestyle intervention was just as effective. It is never too late to start exercising and eating healthy. Living a healthy lifestyle is the best medicine when it comes to preventing Type 2 diabetes."
A New England Journal online summary of the study noted that the "observations are important for the 10 million persons in the United States who are at risk for diabetes."
Said Montez: "The publishing of this work in one of the world's top peer-reviewed journals is a great accomplishment. We look forward to an additional five years of follow-up for patients in all the treatment groups. We will continue to examine cardiovascular endpoints and the long-term effects of the initial weight loss in our patients and the effects of Metformin treatment."
The Diabetes Prevention Program, funded by the National Institutes of Health, the American Diabetes Association and private sponsors, was brought to a close a year early because of the findings. Dr. Haffner and other prominent scientists announced the results last August in
Washington, D.C., but they were not published in the Journal until Feb. 7.
LOOK AHEAD also is funded by the National Institutes of Health.