Weight loss linked to a low calorie diet, followed by various weight management programs, leads to comparable delays until the progression of type 2 diabetes

SAN FRANCISCO, June 8, 2019 / PRNewswire / – When comparing two different diets and two different weight management programs, the results of the PREVIEW international intervention study found a low and similar rate of progression to type 2 diabetes prediabetic people who initially lost weight on a low-calorie diet (LCD), according to a presentation of the symposium titled "Results of the study PREVIEW – Diabetes prevention through a lifestyle intervention and studies of the population in the world "to the American Diabetes Association^® (79th Scientific Sessions of the ADA)^® at the Moscone Convention Center San Francisco. The study showed no difference between the post-weight loss diet and the exercise management program. Participants who initially lost weight in all groups had a 3-year T2D incidence rate of 4%, which was well below expectations. .

In order to determine the most effective lifestyles for the prevention of T2DM in a population of pre-diabetic and overweight people, researchers around the world have launched "PREVention of Diabetes Through Lifestyle." Europe  The purpose of the study was to determine the effects and interactions of different types of diets and exercise regimens on the development of new T2DM cases in patients with prediabetes.

"Further work is needed to explore the reasons for this successful prevention of type 2 diabetes, however, it is likely that the initial weight loss will be combined with extensive education and support of the components of one of the Nutrition plans, in addition to a physical activity program, leads to successful lifestyle changes and to maintaining at least part of the initial weight loss in most people having completed the test, "said one of the chief investigators Ian Macdonald, B.Sc., PhD, Professor of Metabolic Physiology at the University of Nottingham. "The inclusion of an initial period of a low-calorie diet resulting in significant weight loss, preceding a well-structured and effective weight maintenance program, may be a major element of future prevention programs." of diabetes. "

PREVIEW is, to date, the largest multinational trial conducted on the prevention of T2DM in adults with prediabetes through nutrition and exercise. The study started in 2013 and included 2,223 participants using intervention centers in Denmark, Finland, the United Kingdom, the Netherlands, Spain, Bulgaria, Australia, and New Zealand. The 36-month intervention consisted of two phases: a rapid two-month weight reduction period achieved using an LCD monitor (800 kcal / day), followed by 39, a balanced diet and exercise phase of 34 months for maintenance of weight loss including four treatment arms. . The impact of a high protein and low glycemic index (GI) versus moderate, moderately protein diet, badociated with moderate or high intensity physical activity on the incidence of T2DM. and the corresponding clinical criteria has been studied.

Participants were recruited for screening on the basis of their body mbad index and other elements of the diabetes risk score in Finland. In screening, fasting plasma glucose and plasma glucose glucose tolerance two hours after oral administration were used to identify patients with impaired glucose and / or post-glycemic glucose status, defined as pre-diabetic and presenting a high risk of developing T2D. After confirmation of eligibility, participants were included in the trial and randomized into one of four treatment groups. Randomization was stratified by bad and age group (age 25-45, age 46-54, and age 55-70) and sequentially badigned from each stratum to different interventions, providing a uniform distribution of bad and group between the four intervention arms of each group. center.

The researchers organized Clinical Investigation Days (CID) ranging from CID1 (base) to CID7 (end of trial) using data collected from blood tests, urine samples, diaries, body composition evaluations and accelerometers. Serious and undesirable side effects and concomitant medications have been reported. In addition, the instructors conducted a total of 17 group visits throughout the trial to help change lifestyle, including nutrition counseling and physical activity. IDC badessments and group visits were conducted in university settings or badociated clinics. Participants followed advice on nutrition and physical activity in a "real" setting without daily supervision from researchers.

The main hypothesis (based on the DiOGenes study) was a higher protein diet with low glycemic index carbohydrates (LGI) badociated with an initial period of weight loss would be more effective than a moderate protein diet and Glycemic index (GI) diet combined with an initial period of weight loss (according to the Finnish Diabetes Prevention Study and the Diabetes Prevention Program). The study also aimed to determine whether high-intensity, short-term physical activity was superior to moderate-intensity physical activity of longer duration. PREVIEW researchers estimated that the LCD monitor followed by the standard dietary approach badociated with either physical activity program would have a 15-year incidence of T2DT of 15.8% and that the diet HP-LGI maintenance would reduce this incidence to 10.5%.

Of the 2223 originally enrolled, 2,202 were able to lose 8% of their weight during the LCD and January 2019 at the end of the study, there were 962 patients at 36 months. The total number of T2D cases was 62, giving a cumulative DT2 incidence rate of 4% over the three years. There was no difference between the two diets or the two physical activity programs. The main funding for this study came from a FP7 grant from the EU.

"It is tempting to suggest that the initial weight loss in the low calorie diet was one of the major contributors to the results, but additional work is needed to confirm it," said Dr. Macdonald. "The design of the study was such that those who dropped out could not be followed at age 3, so we do not know how many of those 2223 people had developed type 2 diabetes after 36 months These findings however show that by combining a low calorie initial diet to establish significant weight loss, followed by a maintenance diet and a physical activity program along with well-founded counseling on evidence-based behavioral changes, it is possible to maintain the maintenance of long-term weight loss and reduce the risk of developing type 2 diabetes. "

To speak to Dr. Macdonald, please contact the ADA Press Office at the following address: From San Francisco Moscone Convention Center on June 7-11, by phone at 415-978-3606 or by email at [email protected].

The 79th Scientific Sessions of the American Diabetes Association, the world's largest scientific meeting dedicated to diabetes research, prevention and care, will take place June 7 to 11, 2019at the Moscone Center in San Francisco, California. Nearly 15,000 physicians, scientists, health professionals and industry representatives from around the world are expected to meet at scientific sessions to present cutting-edge research, treatment recommendations and advances in diabetes control. During this five-day meeting, participants will receive exclusive access to more than 850 presentations and 2,000 original research presentations, engage in stimulating and engaging discussions with leading diabetes experts, and obtain training credits. Continuing Education (FMC) or Continuing Education (CE). for educational sessions. The program is divided into eight thematic areas: Acute and Chronic Complications; Behavioral medicine, clinical nutrition, education and exercise; Clinical / Therapeutic Diabetes; Epidemiology / genetics; Immunology / Transplantation; Action of insulin / molecular metabolism; Integrated Physiology / Obesity; and islet biology / insulin secretion. Gretchen Youssef, MS, RDN, CDE, Chair of Health Care and Education, will deliver her speech entitled "It's all about access!", The Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will address participants on Sunday, June 9. Join the conversation of scientific sessions on social media using # ADA2019.

About the American Diabetes Association
Every day, more than 4,000 people are diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the country's leading volunteer health organization that fights to counter the diabetes epidemic and help people living with diabetes to flourish. For nearly 80 years, the ADA has been leading discoveries and research to treat, manage and prevent diabetes while working tirelessly for healing. We help people with diabetes to thrive by fighting for their rights and developing programs, advocacy and education to improve their quality of life. Diabetes has brought us together. What we do next will make us connected for life. For more information or to get involved, visit our website at diabete.org or call 1-800-DIABETES (1-800-342-2383). The information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

SOURCE American Diabetes Association

Related Links

http://www.diabetes.org