Doctors routinely make lifestyle recommendations to patients who are at risk for developing type 2 diabetes, but too often the advice falls on deaf ears. Sure, patients are aware of the dangers of continuing with a poor diet and sedentary lifestyle and that changing their habits could prove beneficial over the years. But getting someone to start and stick with a lifestyle intervention is an entirely different story.
However, a follow-up on a 10-year-old study found that if health care providers are intense, engaging, and persistent on somewhat of a heroic level, patients will actually follow their advice. And when they do, the rewards are priceless.
The study looked at diabetes risk in four groups of people – patients who were given standard education and counseling about their risk of type 2 diabetes, patients on the common diabetes drug metformin, those taking a drug from a class of diabetes medications called thiazolidinediones, and patients who underwent rigorous lifestyle intervention.
According to study chair David M. Nathan of Massachusetts General Hospital, “In 10 years, participants in the lifestyle changes group delayed type 2 diabetes by about four years compared with placebo (the group given standard education and counseling), and those in the metformin group delayed it by two years. The benefits of intense lifestyle changes were especially pronounced in the elderly. People age 60 and older lowered their rate of developing type 2 diabetes in the next 10 years by about half.”
The thiazolidinediones arm of the study was cut short due to concerns of liver toxicity. The drugs were introduced in the early 1990s and at the start of the study were considered relatively new. Brand names include Troglitazone (Rezulin), Pioglitazone (Actos), and Rosiglitazone (Avandia).
Rezulin was removed from the market due to an increased incidence of drug-induced hepatitis. Avandia became its replacement but was severely restricted in 2010 after studies linked the drug to fatal cardiovascular events. Actos is still available however in 2011 the Food and Drug Administration (FDA) warned that studies had linked the medication to bladder cancer, especially in patients who used the medication for a year or longer.