Diabetes Not Affected by Lifestyle Intervention!?!

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A recent study published in Annals of Internal Medicine looked at lifestyle intervention and diabetes with some surprising results.  This study was a meta-analysis, which means researchers reviewed all prior studies that looked at lifestyle intervention from databases from 1980-2013. They included studies that looked at interventions dealing with diet, exercise and at least one other component such as smoking cessation or counseling.

Researchers broke the studies down into 2 groups of randomized patients those with pre-diabetes, (people at high risk for developing diabetes) and those with established diabetes. They then looked at how these lifestyle interventions affected these 2 groups.

What they found is that for those at high risk for developing diabetes (pre-diabetics) lifestyle changes did in fact prevent progression and the development of diabetes for up to 10 years post intervention.

However for those patients who already had established diabetes there was no sufficient statistical data to say it improved outcome of the disease. Meaning it did not lower mortality nor did it decrease the risk of complications such as heart disease, stroke, kidney or eye disease. These are the end organ damage that diabetes causes usually secondary to the blood vessel injury it causes over time.

It does bring up an interesting dilemma when the CDC sites the majority of all chronic illnesses, such as diabetes are related to lifestyle. However, as I told my diabetic brother don’t swap the gym membership for the remote just yet!

First, all the prior studies researchers reviewed look at lifestyle intervention for only 6 months which if you don’t have a disease yet but are at high risk for it can make significant difference. However, if you already have an established disease such diabetes, which is a chronic illness that takes years in the making, 6 months is probably not enough of a time frame to see significant change or reversal of damage. Therefore don’t throw out the baby with the bathwater; I think we definitely need to do more long-term research to look at this specific question of diabetes and lifestyle intervention.

And certainly NO ONE can argue that having a healthy lifestyle is harmful in anyway! Healthy living and healthy lifestyle choices can protect you against other diseases such as cancer or heart disease in and of itself. It can help boost your immune system and protect you against infectious diseases. It can keep you active and feeling better as well as living independently longer. It can help keep you from spending your golden years running from one doctor to another.  I am not saying your genes don’t play a role and that you should don’t blame yourself if you do get ill. However just because this study right now does not have the absolute data to prove a health lifestyle can help your diabetes, let’s use something even more rare in medicine…a little common sense!

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