Four-year delay of diabetes reduces death and complications in prediabetic patients

People diagnosed with prediabetes can reduce their long-term risk of death and health complications related to diabetes if they delay the onset of diabetes by as little as four years through diet and exercise. Guangwei Li of the China-Japan Friendship Hospital and colleagues report these findings in a new study published July 9^u in the open access journal PLoS Medicine.

Type 2 diabetes is associated with an increased risk of death and disability and imposes a significant economic burden on individuals and societies worldwide. Lifestyle changes, such as eating a healthy diet and getting more exercise, can delay or reduce the risk of developing diabetes in people diagnosed with impaired glucose tolerance – commonly called pre-diabetes. However, it is unknown how long a person should delay diabetes to ensure better long-term health.

In the new study, researchers looked at health outcomes from 540 prediabetic people who participated in the original Da Qing Diabetes Prevention Study, a six-year trial conducted in the city of Da Qing, China, that began in 1986. Participants were either control group or one of three lifestyle intervention groups, which included a healthy diet, more exercise, or both. The trial continued with participants for more than 30 years.

Li’s team determined the long-term risk of death, cardiovascular events – such as heart attack, stroke or heart failure – and other diabetes-related complications for trial participants. They found that people who remained diabetes-free for at least four years after their initial diagnosis had a significantly lower risk of death and a significantly lower risk of having a cardiovascular event compared to those who developed diabetes earlier. This protective effect was not seen in people who remained non-diabetic for less than the ‘four-year mark’.

Overall, the analysis shows that the longer a prediabetic person can delay the onset of diabetes, the better their long-term health outcomes will be. However, even a few years of maintaining prediabetes can have benefits for years to come.

The authors add, “This study suggests that longer duration of the non-diabetic state in people with IGT has beneficial health effects and reduces mortality. Implementation of effective interventions targeting individuals with IGT should be considered as part of preventive management for diabetes and diabetes-related vascular complications.”