Lifestyle interventions reduce diabetes risk in South Asians
medwireNews: Meta-analysis data show that lifestyle modification interventions can reduce the risk for developing type 2 diabetes by more than a third in high-risk adults of South Asian origin.
Anne Karen Jenum (University of Oslo, Norway) and colleagues say that their findings challenge “our thinking on the assumed limited effect of lifestyle modification interventions in high-risk South Asian individuals,” and strongly support the value of such interventions to prevent diabetes in these people.
They add that “this is important given that the burden of diabetes is substantial and growing, particularly in this group.”
The analysis included individual participant data from six randomized controlled trials (four conducted in Europe, two in India) that assessed the efficacy of dietary and/or physical activity interventions compared with usual care for the prevention of type 2 diabetes in 1816 South Asian adults.
Overall, moderate-quality evidence showed that the interventions reduced the risk for diabetes by a significant 35%, with incidence rates of 12.6% versus 20.0% in the intervention and control groups, respectively.
The absolute risk reduction was 7.4% and this did not differ significantly according to age, sex, BMI, study duration, or the region where the studies were performed, the team reports in Diabetologia.
The researchers also found that at the end of the study period, 2-hour glucose, bodyweight, and waist circumference were all significantly lower in the pooled intervention group than in the control group, with between-group differences of 0.34 mmol/L, 0.75 kg, and 1.16 cm, respectively. There was no significant impact on fasting glucose, however.
The results of these secondary outcomes also did not differ by age, sex, BMI, study duration, and study region, with the exception of a significant interaction between weight loss and study region. Here, participants in the European studies lost significantly more weight than those in the Indian studies (1.10 vs 0.08 kg).
Jenum and co-authors say that “pending deeper understanding of the causation of diabetes in South Asians and the development of new kinds of intervention, this individual participant data meta-analysis of lifestyle modification interventions […] provides evidence of a clinically important 35% relative reduction in diabetes incidence, with [a number needed to treat] of 14 to prevent one case of diabetes over a mean of 2 years.”
They add that their findings provide “support for ongoing strategies underpinned by weight loss, dietary change and increased physical activity to prevent diabetes” that if implemented on a large scale could “reduce the incidence of diabetes in these populations.”
By Laura Cowen
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