By Kathryn Doyle
(Reuters Health) – Organized diet & exercise programs can stave off diabetes for those at risk, according to a new recommendation.
The Community Preventive Services Task Force, an independent, unpaid group of public health & prevention experts who develop recommendations for community health, commissioned a review of 53 studies describing 66 combined diet & physical activity promotion programs. The studies were done between 1991 & 2015.
p> The Task Force found strong evidence that these programs are effective at reducing the number of new cases of diabetes, according to a report in Annals of Internal Medicine.
â€œIf you exercise & eat better, youâ€™ll reduce your risk of developing diabetes,â€ said Dr. Patrick L. Remington, coauthor of the recommendation statement on behalf of the Task Force. â€œBut if you simply tell somebody to eat better & exercise, that does not work.â€
The diet & exercise promotion programs included providers or trained laypeople working directly with participants for at least three months, providing counseling, coaching & support over multiple sessions.
Some moreover included specialists like nutritionists, physiotherapists, individually tailored diet & exercise programs & specific weight-loss goals.
The programs were targeted to teens & adults with â€œpre-diabetes,â€ marked by elevated blood sugar levels that were not yet high enough to be diagnosed with type 2 diabetes.
â€œIn general, people who may be at increased risk for diabetes (both adults & children) include those who are overweight or obese & those who have a sedentary lifestyle,â€ Dr. Ethan Balk of Brown University in Providence, Rhode Island, lead author of the evidence review, told Reuters Health by email.
The review found that community-based programs helped improve weight loss, lower blood sugar & reduce the risk for a after diabetes diagnosis. Some moreover reduced blood sugar & improved cholesterol markers, & none reported any long-term harms related to the programs.
In an economic assessment, the Task Force moreover found that these programs are cost-effective. Half of participants paid less than $653 to take part, & costs were lower for group-based or primary-care based programs.
â€œThis is more cost effective than most of what we do in medicine, yet not cost saving, it does cost something,â€ Remington said by phone. â€œBut the return for those costs are many years of healthy life gained, so we consider it cost effective.â€
Gyms & health clubs already offer these types of programs for a modest fee, he said.
Itâ€™s â€œshocking,â€ he added, â€œthat we are not doing it as a routine part of the health care system. Weâ€™ve designed a healthcare system to treat sick people, not to prevent disease.â€
The first step may be a alter in providersâ€™ attitudes, he said, noting that many doctors do not believe that diabetes can be prevented through lifestyle changes.
â€œI think that the medical community has been so influenced by long term secular trends that theyâ€™ve lost confidence in the individual to treat themselves through lifestyle changes,â€ he said.
Then the insurance & outreach system needs to change, & training laypeople or nonphysician specialists to provide these programs should increase, he said.
â€œThe (Affordable Care Act) doesnâ€™t really cover these type of intense prevention programs,â€ Remington said. â€œGenerally weâ€™ve left people alone with advice.â€
There are National Diabetes Prevention Program resources in every state, & the Centers for Disease Control & Prevention has a registry of recognized programs & a â€œFind a program near youâ€ function (link here: http://1.usa.gov/1vj7p00), Balk said.
SOURCE: http://bit.ly/1M6ih8z, http://bit.ly/1HrtBWf & http://bit.ly/1gxcvQh Annals of Internal Medicine, July 13, 2015.
Task ForceAnnals of Internal Medicinetype 2 diabetes