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27-09-2011 | Diabetes | Article

Physician advice vital to reducing diabetes risk behaviors in young adults


Full abstract

MedWire News: Physician advice is independently associated with the adoption of diabetes risk-reducing behaviors, suggest US researchers.

However, more needs to be done to ensure at-risk adults actually receive such advice, they say.

As reported in the journal Diabetes Care, Man-huei Chang (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) and team examined data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES) for 8598 US adults, aged 20 years or older, without diabetes.

The researchers used logistic regression modeling to investigate the association between three risk-reduction behaviors (controlling or losing weight, increasing physical activity, and reducing the amount of dietary fat or calories), and family history of diabetes.

Overall, they found that 36.2% of the cohort had a family history of diabetes.

Among them, 39.8% reported receiving advice from a physician during the previous year regarding at least one of the three selected behavioral changes, compared with 29.2% of participants with no family history.

Compared with adults without a family history of diabetes, adults with a history were more likely to have controlled or lost weight, than adults without a family history of diabetes (53 vs 47%, respectively). They were also more likely to have increased exercise (49 vs 45%), or to have changed their diet regardless of physician advice (52 vs 45%).

For each individual risk-reduction behavior, more adults with a family history received physician advice than did those without, at 25% versus 17%, respectively, for controlling or losing weight, 32% versus 24% for increasing exercise, and 29% versus 19% for changing diet.

However, among those who received and followed advice, there were no significant differences between patients with and without a history regarding the proportion performing each of the three risk-reducing behaviors (77 vs 81%, 68 vs 71%, and 79 vs 81%, for controlling or losing weight, increasing exercise, and changing diet, respectively).

Univariate analysis showed that when physician advice was given in the previous 12 months, the odds of people engaging in any of the three activities increased 3.8-6.7 times compared with participants who were not given advice. The authors say that physician advice also remained significantly associated with each behavioral change after multivariate adjustment, with ORs of 3.4-5.4.

However, "in spite of the influence of family history in risk-reducing behavior changes and the important role of physician advice on lifestyle changes, our data suggest that more than one half of people with a positive family history of diabetes had not received physician advice on lifestyle changes in the past 12 months," they write.

"It appears likely that the continued development of practical methods and effective strategies to promote behavioral changes is needed to contain, and perhaps reverse, the modern epidemic of diabetes," they conclude.

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By Sally Robertson