A new study published in the international journal JAMA Internal Medicine shows how providing support to help people with prediabetes make small changes to their lifestyle, diet and physical activity can almost halve the risk of developing Type 2 diabetes.
The findings come from the Norfolk Diabetes Prevention Study (NDPS) — the largest diabetes prevention research study in the world in the last 30 years. The NDPS clinical trial ran over eight years and involved more than 1,000 people with prediabetes at high risk of developing Type 2 diabetes.
The study found that support to make modest lifestyle changes, including losing two to three kilograms of weight and increased physical activity over two years, reduced the risk of Type 2 diabetes by 40 to 47 per cent for those categorised as having prediabetes.
There are about eight million people with prediabetes in the UK and 4.5 million have already developed Type 2 diabetes.
The NDPS, funded by £2.5m from the National Institute for Health Research (NIHR), and NIHR CRN Eastern, was led by the Norfolk and Norwich University Hospital (NNUH) and University of East Anglia (UEA), together with colleagues from Ipswich Hospital, and the Universities of Birmingham and Exeter.
The research trial tested a simple lifestyle intervention, which helped people make small achievable lifestyle changes that led to a modest weight loss, and increases in physical activity.
Importantly these changes were sustained for at least two years and the weight lost was not put back on.
Prof Mike Sampson, NDPS Chief Investigator and Consultant in Diabetes at NNUH, said: “We are delighted with the results of this trial, as until now no one was very sure if a real-world lifestyle programme prevented Type 2 diabetes in the prediabetes population we studied, as there have been no clinical trials that had shown this.
“We have now shown a significant effect in Type 2 diabetes prevention, and we can be very optimistic that even a modest weight loss, and an increase in physical activity, in real world programmes like this have a big effect on the risk of getting Type 2 diabetes.
“This is really great news for the eight million people in the UK with a prediabetes diagnosis. The results of this trial, show that diabetes prevention is possible in the same prediabetes populations being treated in the NHS national diabetes prevention programme.
“This is important to know, as the clinical methods for diagnosing diabetes and prediabetes have changed a lot in recent years.”
The Norfolk Diabetes Prevention Study ran between 2011 and 2018 and worked with 135 GP practices in the East of England, and found 144,000 people who were at risk of developing Type 2 diabetes.
In screening sites across the East of England, 13,000 of these people then took a fasting glucose and glycosylated haemoglobin (HbA1c) blood test to detect prediabetes.
More than 1,000 people with prediabetes were then entered into a randomised controlled trial, testing a pragmatic real-world lifestyle intervention, compared to a control group, with average follow-up of just over two years.
NDPS co-investigatro Prof Max Bachmann, from UEA’s Norwich Medical School, said: “The NDPS intervention was delivered in groups which was far less expensive than individual-focused interventions which have previously shown to be effective under optimal conditions.
“For every 11 people who received the NDPS intervention, one person was prevented from getting Type 2 diabetes, which is a real breakthrough.”
Prof Colin Greaves from the University of Birmingham, who jointly led the development of the NDPS intervention, said: “If you have been diagnosed with prediabetes, this approach offers a way to take a different direction in your life — to get off the path to type 2 diabetes and onto the road to a healthier future.”
Prof Jonathan Valabhji, National Clinical Director for Diabetes and Obesity for NHS England, said: “This study with similar referral criteria and a similar intensive lifestyle intervention to the NHS Diabetes Prevention Programme has surpassed expectations in preventing Type 2 diabetes. This is hugely encouraging for the NHS Diabetes Prevention Programme, and what participants might expect to achieve in the longer term.”
Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “We welcome this new research showing that a group-based support programme can help people at high risk of developing type 2 diabetes reduce their risk.