September 28th, 2010
04:43 PM ET

Intensive lifestyle changes improve diabetes risk factors

More exercise and a better, healthier diet can lower type 2 diabetes symptoms according to a new study published in Archives of Internal Medicine Monday.

Researchers looked at more than 5,000 patients between the ages of 55 and 76 who were overweight or obese and had type 2 diabetes. All the participants were given information about diabetes.  Half of the patients were also coached about their exercise program, their weight, their fitness level as well as their blood pressure and blood sugar levels.  This group was encouraged to limit daily food consumption to 1,200 to 1,800 calories and to gradually increase the amount of moderate exercise (like brisk walking) to 175 minutes per week .

Those who received the additional support and coaching "achieved a weight loss of 6.15 percent of their body weight, which is roughly 13 pounds  [on average over four years]," says lead study author Dr. Rena Wing.  The control group only "lost about 1  percent of their body weight, about 2 pounds," Wing adds.

"This study showed with a lifestyle intervention, people can lose weight and keep it off and improve their diabetes, fitness, and improve their heart disease risk factors for the long-term," says Dr. Susan Yanovski, an obesity expert at the National Institutes of Health.

The study also found many of the participants were able to stop taking their diabetes and blood pressure medications.

Yanovski says now it's a matter of determining a cost-effective and easy way to carry out this type of lifestyle intervention in the community to check the long-term effects.  For example if the risk of dying from heart disease or a stroke decreases in these patients.

Last week the FDA decided to restrict the use of the diabetes drug, Avandia in the U.S. to those patients who are not helped by other diabetes drugs.  In Europe, the European Medicines Agency voted that Avandia should be pulled from the market and it banned the manufacturer, GlaxoSmithKline, from advertising the drug.

This new research offers more evidence that lifestyle changes may be able to help reverse the symptoms of type 2 diabetes, to the point where medications are no longer needed.

About 23.6 million Americans (7.8 percent of the U.S. population) have diabetes and about 1.6 million people ages 20 and older get a new diagnosis each year, according to the National Institutes of Health.  Type 2 diabetes happens when your body does not respond correctly to insulin, and the blood sugar doesn't reach the cells to be stored for energy. People who are overweight are more likely to have insulin resistance because fat can interfere with the body's ability to use insulin.

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Filed under: Diabetes • Heart

soundoff (27 Responses)
  1. gen81465

    I agree with this study. I'm now 45 years old, and have been diagnosed diabetic for about 2.5 years. In the last year, I adjusted my eating and exercise habits and lost 17 pounds. Both of these changes were not difficult to do; mostly because changing eating habits was about portion control. I simply cut about 20% of the size of the portion. The results were amazing: fasting blood sugar dropped from 222 to 105; A1C dropped from 9.4 to 5.3 (under 7.0 is normal); overall cholesterol from 210 to 125; LDL (bad cholesterol) dropping from 160 to 65; triglycerides dropping from 285 to 158.

    September 28, 2010 at 22:33 | Report abuse | Reply
    • charle s

      Congratulations. Too bad more people do not follow your example or have access to nutritional support. Dr Andrew Saul make similar recommendation for treating diabetes. See http://doctoryourself.com/diabetes.html

      September 29, 2010 at 08:26 | Report abuse |
    • Michelle

      Exercise and diet is the BEST way to control and prevent diabetes. Start doing it today, not tomorrow.

      September 29, 2010 at 10:18 | Report abuse |
    • Soul

      I did similar changes and results as yours 10 years ago and was in great shape. I hope it lasts for you. My grandfather lived to 80 with it and just changes in diet/exercise. However, for some unexplained reason (stress/illness?) I went straight to Type I... it was like hitting a brick wall. It feels like being starved/no energy. Being healthy and fit did not help in my case.

      I guess my point is the media and doctors focus too much on making money on the side-effects and symptoms and not the cure. Diet and lifesyle changes, cure is not. Also, Insulin is life support not a cure. Stem cells are 100% effective but only for a short period. Our medical research community has not identified the root cause of the disease.

      September 29, 2010 at 11:14 | Report abuse |
    • Mike

      I was diagnosed on August 26th with type 2 diabetes after a glucose tolerance test. My A1C was 7.5 and my weight was 257 and I've just turned 48. Hearing my diagnosis was like a gut punch and insertion of a lap-band with just those little words 'you have diabetes'. At my one-month follow-up my doctor was pleased with my improvements which included adhering to a very low cal (and carb sensitive) diet and daily exercise. As of today my weight is 236 and my average glucose reading is 109. My blood pressure was 97/64. No meds for me and with some willpower I will make myself well again soon. I encourage those of you who are inactive and overweight to really try to at least make small changes as they will make a difference.

      September 29, 2010 at 11:46 | Report abuse |
  2. daretodream

    Great article

    September 28, 2010 at 22:45 | Report abuse | Reply
  3. kyle

    good "coaching" as they call it can be really helpful, but the person has to be ready and willing to change their lifestyle. If they aren't even thinking about changing their life chances are they're far away from any major changes. Check out http://www.diet-myths.com for more great info on weight loss and living a healthy lifestyle.

    September 29, 2010 at 01:36 | Report abuse | Reply
  4. Katey

    Absolutely correct. I am not a Type 2 diabetic, but my sugar went way up recently. For the past month I cut out ALL sugar, All white stuff and the only sat fat I'm eating is skinless, boneless dark meat of chicken occasionally. Mostly seafood, nuts, vegs, seeds, fruit and whole grains and lots of water. I don't worry about portions, just the content. I've lost about 8 lbs in the month and my sugar has dropped 80 points!!! I exercise regularly (5 to 6 days a week), but I always did that. This proves to me it's the food you put in your mouth that makes the biggest difference. Every obese person, including children, should make drastic changes to improve their health outlook. It seems like today people are proud to say "I'm a diabetic".....go figure. Read up on the consequences of this disease; it may be the motivation you need to make those changes.

    September 29, 2010 at 08:56 | Report abuse | Reply
    • Health Food For Thought

      it's never a good idea to cut out the white stuff! Nobody wins there.

      September 29, 2010 at 10:38 | Report abuse |
  5. patrick davidson

    my bro is class two and cant put on weight. he runs and rides his bike daily and the neropathy in his feet is a daily horror and prevents him from working. he is 6 2 and wieghs 175lbs. eats five times a day large volumes of meats. very little carbos except wheat varieties.

    he cant drive because he cant feel the amount of pressure to put on when applying the brakes.

    September 29, 2010 at 10:31 | Report abuse | Reply
    • Jennifer

      That's not type 2, that's type 1! There's a frequently mis-diagnosed variant they're now calling LADA, for late-onset type 1 adults. Your brother needs to get to an endocrinologist who can give him a proper diagnosis and put him on insulin fast!

      September 29, 2010 at 11:10 | Report abuse |
  6. Martin

    i wonder how much they got paid for this study? This is nothing new in the world of Type 2 diabetes, doctors have been telling patients this for YEARS.

    If ANYONE follows a diabetic diet, they will lose weight, period, even without exercise.

    However, with exercise, they will have a dramatic weight loss. If you cut out sugar and salt, and drastically reduce carbs and fat all at the same time, you will nt ice a big difference. I did this at doctor's suggestion after being diagnosed diabetic type 2, and lost nearly 60 lbs in 6 months. I also swim for about 20-30 minutes 3 times a week.

    September 29, 2010 at 10:35 | Report abuse | Reply
    • Beth


      many people will lose weight on a low carb diet ( which is NOT your typical diabetic diet endorsed by the ADA ), but level of in insulin resistance ( you were caught early on.. which is great and lucky ) and typs of meds will also affect the amount of weight loss, if any.

      Careful when you say ALL.

      September 29, 2010 at 10:56 | Report abuse |
  7. Eric of Reseda

    And this is why I have lost most of my faith in the medical community. I am a Type 2-er, and my answer to all this is...DUH! This information – exercise and diet as a means of controlling the disease – has SO long been know namong diabetics with half a brain, and CERTAINLY any doctor worth their salt, that you have to believe it has been suppressed in favor of drug therapy. Big Pharma has even the most well-meaning docs in their pocket. Conspiracy? No, just the manifestion of a medical field culture that has been twisted to prefer treatment/surgery over prevention over natural cures. And the Ameircan Diabetes Association (ADA) is a SHAM! For instance, I was just in the hospital for two weeks (staph infection after minor knee surgery), and I was given the ADA-prescribed diet. Myt first meal consisted of eggs, potatoes, pancakes, syrup, fruit! Now, any diabetic knows that THAT sort of meal will cause a dramatic spike in blood glucose. The syrup was fake, to their minor credit. I told them to take everything back but the eggs. But it was amazing how much carbohydrate they tried to shove down my throat. Criminal! Not unlike the way docs have been trying to shove Avandia down our throats, DESPITE long-known reports that this drug contributes to heart disease...the #1 killer of diabetics.

    September 29, 2010 at 10:46 | Report abuse | Reply
    • David

      >>that you have to believe it has been suppressed in favor of drug therapy.<<

      No, there's no evil conspiracy here. The problem is that people find it very difficult to CHANGE THEIR HABITS of eating and physical activity. It is patients who want a miracle drug treatment so that they do not have to do the hard work of changing their habits. Many docs have simply given up trying to persuade their patients to make these changes, as it is about as likely to succeed as trying to teach a pig to sing: it won't work and it annoys the pig.

      September 29, 2010 at 11:28 | Report abuse |
    • Braveshopper

      Eric I had the same thing happen to me at the HOSPITAL. When I asked them why I got vanilla wafers, mashed potatoes, cake, rolls, toast in the morning, and so forth, the nurse said they couldn't cater to everyone! The answer to their transgretion was to give me insulin.

      It's incredible, isn't it!

      To respond to others here, I am trying, as you all are. For me, I've basically gone vegetarian. Not an easy path for a diabetic, but do-able. I don't have weight issues, mine is generational type 2 diabetes.
      What makes me laugh are the recipes at so called 'diabetes' websites!

      September 29, 2010 at 11:31 | Report abuse |
    • Dan

      Nail on the head but missed the culprit here i think – INSURANCE COMPANIES. Want to fix health and healthcare in this Country then insurance should be spending more on preventative care and tests early on instead of treating the disease AFTER it is entrenched. Maybe i am stupid but thinking a $50.00 test for diabetes or cancer or whatever ailment there is and more spent on education would be MUCH cheaper than treating the disease and the side effects of the disease. I too am type-2 (400 pounds) and get little or no dietician help or education. Would be so much nicer if I could honestly. All on me though.

      September 29, 2010 at 17:58 | Report abuse |
  8. jacquie

    Mr. Davidson, my husband has Type 2 and had some of hte same problems just not as severe in his feet. He was treated at the Whitaker Wellness Center in Newport Beach CA with infared red therapy and it helped him tremendously. Your brother can get the units for home, with the auto shut off because otherwise if he can't feel anything he might not turn it off and it may cause burns. Look up Anodine Heat Units. As far as diet, this country has a poor food supply, there are no nutrients in our food so you have to eat so much more of it to feel like you ate anything and to get some vitamins. No wonder people are gaining weight. I go to Europe and eat bread, cheese and fois gra and LOSE weight because a little bit of it is satisfying because it actually has nutrients in it. Big Agra basically is killing us.

    September 29, 2010 at 10:48 | Report abuse | Reply
  9. Susan

    It's sad that some doctors are not giving their patients this kind of advice/support. My husband was seeing a Dr. for his diabetes, but no education on what he really needed to do, besides taking meds. I found him a new Dr. who has a dietician & lab on site. It has made a huge difference. He's lost over 100 lbs. & has made a lifestyle change because he has been educated on exactly what to eat, what to avoid. Some Drs. are just negligent in their obligation to their patients, I think.

    September 29, 2010 at 10:49 | Report abuse | Reply
  10. Victor

    Great article
    I am a 57 year old male, 5' 7", currently at 227 Lbs. Recently my doctor told me I had elevated sugar levels (AC1- 7.3), and wanted me to start taking medication and attend education classes. I was in a state of denial. I could not even say I had type 2 diabetes.
    I have made some changes in my diet, but my wife & co-workers hear me bitch about it every day. This article helps me realize that I am not alone, when it comes to making some major changes in diet & excercise. I am a basic couch potatoe when I come home from work, but I have moved the treadmill from the garage to the living room, so I can watch TV & walk. I also purchased smaller plates this weekend, to help with portion control. Now if I can just get my wife to stop asking: "is that all you are going EAT"???

    September 29, 2010 at 11:15 | Report abuse | Reply
  11. Michele Gomis

    As a type II and not overweight at diagnosis, I'd like to see progress on how to treat this disease for people who can't just loose weight and get better. Wish I could do that. I received a gene from a grandmother who gave me the gift that keeps on giving.

    And yes, the info in this article is old for those of us who paid attention during counseling sessions after diagnosis. Given the increase in diabetics a little repetition doesn't hurt.

    And by the way, I think that nobody is "proud" to announce their diabetes....(a baffling and pointless insult to other comments to assure personal superiority, but seemingly required in CNN posts more and more).

    September 29, 2010 at 11:17 | Report abuse | Reply
  12. Kat

    I weighed 345 one year ago and was diagnosed with type 2 diabetes–my A1C # was 8.6–and I had been following a low fat diet faithfully for 2 years with a weight loss of 4 lbs. Yep, 4 lbs in 2 years, and a big ol' case of diabetes. I saw three doctors, and NONE of them wanted to discuss diet as related to diabetes; they all three wanted to immediately put me on metformin instead. I refused, did some real research, began to follow a very low-carb diet, and began to test my blood sugar up to 9 times per day..straight out of bed, before each meal, 2 hours after each meal, and before bed, and I kept a simple chart of my readings. If a food made my blood sugar spike, I simply removed it from my diet. In 4 months, I'd lost 30 lbs and my A1C# was 5.2. It has remained between 5.0 and 5.2 since March, even though I still weigh just under 300 lbs. I have since added exercise to the mix, and have lost a total of 48 lbs in 9 months with very little effort other than completely removing sugar and starches from my diet, and walking for 30-45 mins 4 days per week. I eat a quantity of food that keeps me full, and I no longer have cravings which send me roaming through the kitchen, looking for something to mindlessly eat. While my numbers were never really awful, now they are stellar–total cholesterol is 145, and my good cholesterol goes higher each time I go to the doctor, presumably because of the exercise I'm now doing. My triglycerides are at 137, and my blood pressure is normal, although it was never really high. Diabetes will kill you, as it is killing my mother, even though she is on metformin AND insulin. There is no money in it for anyone to tell you that dietary changes are the most efficient way to control this disease. Remember how it used to be referred to as 'sugar diabetes'? There was a reason for that...

    September 29, 2010 at 11:21 | Report abuse | Reply
  13. pat

    Just because someone has type 2 diabetes for years does not mean they are doing anything about it. I was told again and again to change my diet and exercise but that advice went to closed ears. Suddenly this year, I decided to take my doctor's advice and attend a diabetes education class. Now I have been eating right and walking and my numbers have come down remarkably. Who knows why we begin to hear when we shut it out for years? Repetition is a good thing – diabetics need to keep hearing it, especially those relying on meds alone. Get started doing what you should be doing and don't let those complications of diabetes get you!

    September 29, 2010 at 11:34 | Report abuse | Reply
  14. Laurie

    There are also millions of people out there with metabolic syndrome or pre-diabetes (blood sugars elevated but not yet at stage to be diagnosed as diabetes...belly fat, stress, poor nutrition, trouble losing weight) who need to get serious about these same changes. I am one, and with the help of supplements, taking my blood sugar fairly regularly , cutting out processed foods , and exercise, I have already made big changes in my numbers although the weight loss isn't spectacularly fast. We are the generations of the easy fix, the "remote" generation, we want it now and we want to expend as little energy as possible to get it. I am feeling so much better, but it disgusts me to see all the unhealthy foods advertised on tv, and all the big Pharma ads that push pills for conditions that people may only think they have. We all need to grow up and realize that we have to take charge of ourselves, and our doctors should be scaring us to death about the consequences of not eating right, nor exercising, not just smiling and writing scripts. I've finally "grown up" at the age of 57 and can see myself living an active and healthy life into my 80's. Go visit most long term care facilities, go to the va and visit a few vets with chronic diabetes. Scare yourself if no one else will do it.

    September 29, 2010 at 16:25 | Report abuse | Reply
  15. Kirsten

    I am a type 1 diabetic and am only 15 years old. I am 123 lbs and 5'4". I didn't ask this to happen to me. Type 1 diabetes can't be prevented but type 2 can! Of course diet and exercise are prevention! if people just could cut out all that excess sugar and try to exercise or even do some physical activity, type 2 diabetes could drastically reduce in numbers. so people, take the time to look at yourself and try to get healthy.

    September 29, 2010 at 18:30 | Report abuse | Reply
  16. Alan

    I agree with this study. Even more, I agree with the diet Bill Clinton mentioned as his method of losing weight. In a recent interview he talked about following the plant based diet studied by T. Colin Campbell in the China Study. Their reseach shows that a plant based diet can reduce or eliminate heart disease, type 2 diabetes and many other diseases affecting todays individuals. The various meat and dairy industries appear to want to squelch any mention of such diets. Bill Clinton mentioned he lost the 25 pounds with this diet and that he was doing it to protect his heart and to avoid a recurrence of the artery clogging that required his recent stent.

    September 30, 2010 at 11:49 | Report abuse | Reply
  17. Janet


    Diabetes is a direct cause of food chemcicals that make BILLIONS$$$$. This has been proven !

    The diabetes Drug makers like GLAXO made 50 BILLIONS$$$ in one year withnot cure! The FDA knows about the food chemicals. A senate investigator just testified that the FDA knew diabetes drugs would harm!!

    A filmmaker has been eversing diabetes in now 10 countries WITHOUT MEDICATIONS but the drug comapnies do not promote this. see here http://spirithappy.wordpress.com
    or just google SPIRIT HAPPY DIET

    September 30, 2010 at 16:37 | Report abuse | Reply

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