Chinese adults with “pre-diabetes” who adopted a healthy diet and exercised for 6 years were much less likely to progress to full blown diabetes over the next 14 years as their pre-diabetic counterparts who made no healthy lifestyle changes.

Researchers say the study, reported in The Lancet medical journal shows that making lifestyle changes “produce a durable and long-lasting reduction in incidence of type 2 diabetes.”

Several major studies have shown that lifestyle changes can help prevent or at least delay type 2 diabetes in high-risk individuals with impaired glucose tolerance, a precursor to diabetes. However, questions remain over how long these strategies remain effective after the lifestyle intervention.

As part of a large Chinese diabetes prevention study, 577 pre-diabetic adults were randomly assigned in 1986 to a “control group,” in which no changes were made, or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise).

The goal of the combined lifestyle intervention was to boost vegetable intake and lower alcohol and sugar intake; get overweight or obese people to lose weight by eating less; and boost physical activity.

Dr. Guangwei Li, from China-Japan Friendship Hospital, Beijing, and colleagues report that the combined lifestyle intervention reduced the occurrence of diabetes by more than half (51 percent) during the 6-year active intervention period, and by 43 percent up to 14 years after the active intervention period ended, compared with control subjects who made no changes.

Moreover, the onset of diabetes was also delayed by 3 to 6 years, on average, with lifestyle intervention.

“Since around 3 million excess deaths a year are attributable to diabetes worldwide, lifestyle interventions seem to be a justifiable public health action,” Li’s team concludes.

In a commentary published with the study, Drs. Jaana Lindstrom and Mattii Uusitupa of the University if Helskinki and the University of Kuopio, Finland, think lifestyle intervention “should start much earlier” when people have normal blood sugar levels “to achieve true primary prevention of 2 diabetes and its main consequence, cardiovascular disease.”

SOURCE: The Lancet, May 24, 2008.