Lifestyle Program to Reduce the Risk of Various Chronic Diseases in People with Prediabetes
JAKARTA - A structured lifestyle program significantly reduces the risk of developing several chronic diseases in adults with prediabetes compared to placebo. Meanwhile, the metformin group did not show a statistically significant reduction in the risk of multimorbidity.
The National Institutes of Health or NIH, through its official website, quoted Thursday, July 16, said the findings came from a clinical trial that followed participants for more than two decades. The results of the study were published in the journal JAMA.
Multimorbidity is a condition when a person has two or more chronic diseases.
The study involved 1,173 people at high risk of diabetes. Clinical trials were conducted at 27 locations in the United States.
The participants were enrolled in Medicare and consented to the use of their health care claims data for research.
In the initial phase of the Diabetes Prevention Program or DPP, which took place from 1996 to 1999, participants were randomly divided into three groups. They followed an intensive lifestyle program, received metformin, or received a placebo.
Metformin is a drug commonly used to treat type 2 diabetes. Placebo is a treatment without active drugs that is used as a comparator in studies.
Participants then took part in the DPP Outcomes Study and were monitored until 2021.
The lifestyle group received 16 individual sessions, then monthly sessions for about two years. The program targets a reduction in calorie and fat intake, physical activity of at least 150 minutes per week, and weight loss of at least 7 percent from the initial condition.
After the initial trial was completed, all participants from the three groups were offered an intensive lifestyle program in groups for six months. At the next monitoring stage, all participants were offered group lifestyle sessions every three months. Participants from the initial lifestyle group received additional sessions twice a year.
Previous research has shown that metformin and lifestyle programs can both prevent or delay diabetes and metabolic syndrome. This latest study specifically tested whether the two could also prevent or delay the onset of several chronic diseases at once.
At the end of the monitoring period, as many as 85 percent of participants experienced two or more chronic diseases.
The figure reached 82 percent in the lifestyle group, 85 percent in the metformin group, and 87 percent in the placebo group.
Compared to the placebo group, participants in the lifestyle program had a 21 percent lower risk of developing two chronic diseases and a 25 percent lower risk of developing three chronic diseases.
The metformin group did not experience a statistically significant reduction in the risk of multimorbidity.
The study looked at 15 chronic diseases commonly recorded in Medicare data. Among them are high blood pressure, heart disease, stroke, arthritis, chronic kidney disease, chronic obstructive pulmonary disease or COPD, cancer, depression, dementia, osteoporosis, and diabetes.
"Multimorbidity is a common problem, while only a few interventions have been shown to prevent or delay the onset of various chronic diseases," said the lead author of the study from the National Institute on Aging, Marcel Salive.
According to Salive, the results of the study show that a healthy lifestyle program can significantly reduce the burden of multimorbidity.
Director of the National Institute of Diabetes and Digestive and Kidney Diseases, Griffin P. Rodgers, said the benefits of diet and exercise are not limited to diabetes prevention.
"Lifestyle programs that focus on diet and exercise can continue to reduce the risk of various chronic diseases, not just diabetes," said Rodgers.
According to Rodgers, maintaining healthy habits in people at risk of diabetes can help reduce the burden on individuals' health and health service spending.
The results of the study remain visible even though diabetes is not included in the definition of multimorbidity.