Walking
30 Minutes a Day and Diet
Can Cut Diabetes Risk
Dramatically
By Lauran Neergaard -
Associated
Press
WASHINGTON (AP) — Doctors now have
proof that regular exercise and weight loss can dramatically cut millions of
Americans' chances of getting diabetes — and it doesn't take a starvation
diet or running a marathon.
"Every one of us can go out and walk 30
minutes each and every day and that's all it takes," Health and Human Services
Secretary Tommy Thompson said in announcing the new findings Wednesday.
Walking and dropping, on average, 15 pounds
helped people with a very high risk of getting the most common form of diabetes
cut those odds by 58 percent, concluded the study by the National Institutes of
Health.
For people who can't do that, a daily pill
called metformin may be an option, the study also found. Metformin cut the
diabetes risk by 31 percent — not nearly as effective as changing
lifestyle and an option that does risk side effects. Still, it's the first
medication ever proven protective against diabetes.
Some 10 million Americans are at very high
risk of getting Type 2, or adult-onset, diabetes and could benefit from the
findings — if only they knew they were at risk.
"We're not doomed to seeing this epidemic go
on forever if we have the will, collectively, to implement these modest
changes,'' said Dr. Allen Spiegel, director of NIH's National Institute of
Diabetes and Digestive and Kidney Diseases.
Now the question is how to find all those
people who need help. Diabetes screening is not routine. And even patients who
know they're at risk aren't likely to get all the help the NIH's massive study
offered: one-on-one diet advice, cooking classes, gym classes, support groups.
"We're going to need to rethink how we
approach care and prevention,'' said Yale University's Dr. Robert Sherwin, past
president of the American Diabetes Association.
So the ADA is teaming with government
scientists to recommend the next steps, such as how Americans should be tested
for their diabetes risk and whether health insurance should pay for any diet
and exercise help.
Some 16 million Americans have diabetes, but
experts say at least a third don't know it is silently festering in their
bodies. It's a leading cause of blindness, kidney failure, limb amputations and
heart disease. It kills 180,000 Americans annually, and costs the nation $100
billion in health bills each year.
Type 2 diabetes — where people
gradually lose the ability to use insulin, a hormone crucial to converting
glucose into energy — accounts for most cases. It's increasing at epidemic
proportions as Americans get older, fatter and less active.
Risk factors include being over age 40;
being overweight; being black, Hispanic or American Indian; and having diabetic
relatives.
The NIH study enrolled 3,234 Americans who
not only had those risk factors but also had an exam — the oral glucose
tolerance test — that showed their bodies already weren't properly
processing blood sugar. Almost half were minorities.
Fifty-eight percent who did moderate
exercise for 150 minutes a week and lost 5 to 7 percent of their initial body
weight staved off diabetes for at least the three years of the study.
The benefit was seen for every race and
ethnicity. The oldest people, over 60, cut their risk most, by 71 percent.
How much work did it take? Most walked. They
ate 1,200 to 1,800 calories a day. They cut fat consumption to 25 percent of
daily calories, helped by such dietitians' tips as to choose baked chicken over
fried and season vegetables with lemon, not butter.
"I was pretty much a couch potato,'' said
Dianne Dunn, 48, of Washington, who lost 31 pounds during the study. "When I
walked up my block that first time I was huffing and puffing. Now I can walk
six miles.''
Metformin cut risk by 31 percent and so is a
second option, which could help people who physically can't exercise, said lead
researcher Dr. David Nathan of Massachusetts General Hospital. No one knows if
taking the daily pill plus diet and exercise would work better, because that
wasn't studied. Also, metformin cannot be taken by people with kidney disease
because of a rare but life-threatening side effect.
The Food and Drug Administration has
approved metformin only as a diabetes treatment. Bristol-Myers Squibb, which
sells it under the brand name Glucophage, is considering whether to seek FDA
approval to market the drug as a way to prevent diabetes, too. |
