The lifestyle changes, which included diet
modifications and exercise, also helped lower death rates,
especially among women.
The data are based on the six-year Da Qing Diabetes Prevention
Study. Participants began the study with higher-than-normal blood
sugar levels, but not high enough to be diagnosed with diabetes.
Researchers wanted to see if they could help prevent or delay a
diagnosis of full-on diabetes.
"Diabetes is strongly associated with the increased risk of
cardiovascular disease event and mortality," Dr. Guangwei Li told
Reuters Health in an email.
Li, from the China-Japan Friendship Hospital in Beijing, said the
prevalence of diabetes will increase with rapid economic development
in China and all over the world.
"We have to do something active to delay the development of diabetes
in high risk populations," Li said.
For the new report, Li and colleagues followed up with 568
participants of the original study that began in 1986 in Da Qing,
Those people had been randomly placed into one of three intervention
groups (diet, exercise or diet plus exercise) or a comparison group.
The diet intervention was meant to help heavy people lose weight and
normal-weight people reduce the amount of simple carbohydrates they
ate and the amount of alcohol they drank. The goal of the exercise
program was to increase the amount of leisure time participants
spent being active.
The original study indicated that all three intervention groups had
a reduced risk of developing type 2 diabetes when the study ended in
The current researchers wanted to see if the lifestyle changes made
in the original study still had an impact on the development of
diabetes and death rates many years later. They compared medical
records and death certificates of 430 participants in the
intervention groups and 138 members of the comparison group.
By the end of 2009, 28 percent of participants in the intervention
groups had died, compared to 38 percent of the controls.
When they looked specifically at heart disease, the researchers
found that 12 percent of the intervention group participants had
died of heart-related conditions, compared to 20 percent of the
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Almost all of the benefit was found in women - there was very
little difference in death rates among men based on whether they
went through one of the lifestyle programs.
The researchers also compared diabetes diagnoses and found that 73
percent of the intervention group had developed diabetes through
2009, compared to 90 percent of the control group. Those findings
were similar for men and women, they report in The Lancet Diabetes
"The group based lifestyle interventions over a six-year period have
long-term effects on prevention of diabetes beyond the period of
active intervention," Li said. "It is worth taking active action to
prevent diabetes to reduce the risk of cardiovascular disease and
"The intervention seemed to have a disproportionately large
effect in women," writes Nicholas Wareham in an editorial published
with the study.
Wareham, from the University of Cambridge in the UK, did not respond
to an interview request. It's possible that differences between men
and women were a result of how participants responded to the
interventions, he writes. But because there are no data on people's
lifestyle habits during the study period, that's impossible to say.
"However, this point should not detract from the main finding: that
interventions aimed at changing diet and physical activity were
effective for reduction of long-term health risks," Wareham
Lancet Diabetes and Endocrinology, online April 3, 2014.
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