A four-year delay in diabetes reduces mortality and complications in prediabetics

People with prediabetes can reduce their long-term risk of death and diabetes-related health complications by delaying the onset of diabetes by just four years through diet and exercise. Guangwei Li of China-Japan Friendship Hospital and colleagues report these findings in a new study published July 9.^th in the open access journal PLOS Medicine.

Type 2 diabetes is associated with an increased risk of death and disability and places a significant economic burden on individuals and societies worldwide. Lifestyle changes, such as eating a healthy diet and increasing physical activity, may delay or reduce the risk of developing diabetes in people diagnosed with impaired glucose tolerance – commonly known as prediabetes. However, it is not known how long a person needs to delay diabetes to ensure better long-term health.

In the new study, researchers examined the health of 540 prediabetic people who participated in the original Da Qing Diabetes Prevention Study, a six-year study conducted in the Chinese city of Da Qing in 1986. Participants were in either a control group or one of three lifestyle intervention groups that included a healthy diet, increased exercise, or both. The study followed participants for more than 30 years.

Li’s team determined the long-term risk of death, cardiovascular events – such as heart attack, stroke or heart failure – and other diabetes-related complications for the study participants. They found that people who remained non-diabetic for at least four years after their initial diagnosis had a significantly lower risk of death and a significantly lower risk of a cardiovascular event than people who developed diabetes earlier. This protective effect was not observed in people who remained non-diabetic for less than the “four-year threshold.”

Overall, the analysis suggests that the longer a person with prediabetes can delay the development of diabetes, the better their long-term health outcomes. However, maintaining prediabetes status for even just a few years can provide benefits for years to come.

The authors add: “This study suggests that prolonged non-diabetes status in patients with IGT has beneficial health effects and reduces mortality. Implementation of effective interventions for patients with IGT should be considered as part of the preventive treatment of diabetes and diabetes-related vascular complications.”