Science of diabetes; what do long-term studies tell us about this and other diseases?

Posted in , , , by Miss Kornelija Dedelaite

When type 2 diabetes is detected in a person who has prediabetes, or early indications of the disease, it can frequently be slowed down or prevented, as the Diabetes Prevention Programme (DPP) revealed two decades ago. A balanced diet low in calories and at least 150 minutes of exercise was one strategy examined to assist participants in losing at least 7% of their body weight. Metformin treatment is a medication that is commonly used to treat diabetes. A control group that received a placebo (fake) pill was contrasted with the two.

Why is diabetes prevention and slowing important?

Among chronic disorders, type 2 diabetes is one of the most prevalent worldwide. It increases the chance of early death and disability over time by causing kidney difficulties, nerve damage, heart disease, and eye issues. If a person’s lab work indicates that they have prediabetes, they can delay or avoid the onset of type 2 diabetes with the use of proven treatments. People may be able to maintain their health for many years as a result.

What was discovered in the follow-up study?

The original study’s findings demonstrate that metformin therapy and lifestyle changes both significantly reduce the risk of diabetes in those with prediabetes. In comparison to the control group, the risk was lowered by 58% and 31%, respectively.

The Diabetes Prevention Programme Outcomes Study (DPPOS), a follow-up observation study, extended an invitation to the 3,234 initial DPP cohort participants to continue participating. Since the majority of individuals have now been tracked for more than 20 years, there is a rare chance to evaluate several significant health outcomes.

The average participant fatalities after 21 years were examined in the most recent analysis, along with deaths from cancer and cardiovascular disease. When comparing the death rates of those initially assigned to the metformin and rigorous lifestyle arms of the study with those originally placed in the control group, the researchers observed no change.

Does this imply that these tactics are not as effective as previously believed?

Not at all! To make sense of these findings, it is necessary to place things in perspective.

Initially, all of the initial DPP study participants were invited to continue participating in the program’s observation phase and were informed about the advantages of metformin and comprehensive lifestyle adjustment. Since lifestyle change had the most impact, researchers were morally obligated to tell each participant of the results and encourage them to put these recommendations into practice. In actuality, after the DPP trial concluded, all participants were given access to lifestyle adjustment sessions.

It’s possible that a large number of follow-up study participants made some positive adjustments to their diets and exercise regimens. This would make it harder to determine how significant lifestyle changes have an impact on later health outcomes.

Second, only one group used metformin in the original study. Any participant in the follow-up research who developed type 2 diabetes was advised to consult their primary care physician for guidance on blood sugar management.

The first-line treatment for type 2 diabetes is metformin. Consequently, metformin was routinely administered to individuals who developed diabetes, regardless of whether they were in the intensive lifestyle modification or control groups. The three groups’ ability to distinguish from one another weakened over time. Although statistical tests were conducted in this current investigation to remove this bias without impacting the primary findings, some bias cannot be completely ruled out.

Overall, there were few deaths in the DPPOS

At the start of the research, the participants in these trials were, on average, 50 years old and in generally good condition. This helps explain lower-than-usual death rates when compared to results from previous US studies on type 2 diabetes or even results from international studies on diabetes prevention.

It’s also noteworthy that the primary cause of death in the follow-up research was cancer rather than heart issues, strokes, or other cardiovascular diseases. Cardiovascular disease has long led the list of diseases that affect the general population.

This could be a situation when broad initiatives to lower adult cardiovascular disease are implemented. However, this benefit might also make it harder for researchers to detect appreciable variations in death rates between the three groups in the DPPOS.

With all this information, what are we supposed to do?

The best course of action is to keep trying to delay or avoid diabetes. Both for each of us personally and for our nation as a whole, that is beneficial. These are the findings from our investigation.

In case you are prediabetic:

  • The most effective method of lowering the risk of type 2 diabetes remains to be intensive lifestyle adjustment. It can reduce your risk of heart disease and stroke, help you receive extra advantages associated with weight loss, and help you prevent or delay diabetes.
  • Metformin is a cheap, safe medication that lowers the chance of getting diabetes and has few adverse effects. Individuals under 60 years old, those with a BMI above 35, and women with a history of gestational diabetes benefit most from metformin.

Remember that each person’s optimal course of action for preventing type 2 diabetes may depend on a variety of factors. Important variables to take into account include age, race and ethnicity, other medical issues, total risk of type 2 diabetes, and the kinds of techniques a person can use. Consult your healthcare team to determine the optimal mix of preventative measures for you if you have prediabetes, diabetes in your family, or are worried about getting the disease.

Preventive measures with Echelon Health

In terms of managing personal healthcare, private health checkups are a major advancement. They provide a comprehensive, individualised approach that surpasses the scope of typical health evaluations. Choosing to have a private health checkup is a proactive move that people take to ensure a healthy future, in addition to investing in their current well-being.

In the modern world, where proactive health management can result in long-term health advantages and a higher quality of life, this all-encompassing approach to health is vital. Private health checks are expected to become a crucial component of health management for people who value their health and well-being as a result of advances in medical technology and an increasing emphasis on preventative healthcare.

The Platinum Assessment from Echelon Health is the most adept at diagnosing a wide range of illnesses. In fact, we can identify up to 92% and 95% of the preventable causes of death in men and women, respectively, using the Platinum Assessment.

The following is a complete list of scans that are part of the Platinum Assessment:

  • Medical Questionnaire
  • Blood Test
  • ECG
  • CT Aorta
  • CT Heart
  • CT Coronary Angiogram
  • CT Chest
  • CT Pelvis
  • CT Virtual Colonoscopy
  • CT Bone Density
  • EOS
  • CT Upright Skeleton
  • MRI Brain
  • MRI Cerebral Artery Angiogram
  • MRI Carotid Artery Angiogram
  • MRI Prostate
  • Ultrasound Thyroid
  • Ultrasound Testes/Ovaries
  • Digital Mammogram
  • Full Body Mole Screen
  • Final consultation