Who is at High Risk for Type 2 Diabetes?
Diabetes medication and lifestyle changes can positively impact type 2 diabetes risk factors and help those at risk of diabetes.
Type 2 Diabetes Risk Factors
The findings of the Diabetes Prevention Program (DPP), a major clinical trial, released in August 2001, showed that people at high risk for type 2 diabetes could sharply lower their chances of developing the disorder through diet and exercise. In addition, treatment with the oral diabetes drug metformin also reduced diabetes risk, though less dramatically. Metformin lowers the amount of glucose released by the liver and also fights insulin resistance, a condition in which the body doesn't use insulin properly.
Participants randomly assigned to intensive lifestyle intervention reduced their risk of getting type 2 diabetes by 58 percent. On average, this group maintained their physical activity at 30 minutes per day, usually with walking or other moderate intensity exercise, and lost 5 to 7 percent of their body weight. Participants randomized to treatment with metformin reduced their risk of getting type 2 diabetes by 31 percent.
Of the 3,234 participants enrolled in the DPP, 45 percent were from minority groups that suffer disproportionately from type 2 diabetes: African Americans, Hispanics/ Latinos, Asian Americans and Pacific Islanders, and American Indians. The DPP also recruited other groups known to be at higher risk for type 2 diabetes, including individuals ages 60 or older, women with a history of gestational diabetes, and people with a first-degree relative with type 2 diabetes.
Participants are still being followed to check for long-term effects of the interventions, including the effects on cardiovascular disease (heart disease). Recent analyses of data from the DPP have added to the evidence that lifestyle changes are especially effective in helping to reduce the risk of developing conditions associated with type 2 diabetes, including high blood pressure and the metabolic syndrome. Researchers also confirmed that study participants carrying two copies of a gene variant that significantly increased their risk of developing diabetes benefited from lifestyle changes as much as or more than those without the gene variant.
Type 2 Diabetes in Children and Teens
Two studies focusing on type 2 diabetes in children and teens are under way. The Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study, a 13-site study sponsored by the NIDDK, will compare treatments for type 2 diabetes in children and teens. Participants will undergo one of three treatments:
- taking one diabetes medication—metformin
- taking two diabetes medications—metformin and rosiglitazone, another medication that fights insulin resistance
- taking metformin and participating in an intensive lifestyle change program designed to promote weight loss by cutting calories and increasing physical activity
The main goal of the study is to determine how well each type of treatment controls blood glucose levels. The study also will evaluate how long each type of treatment is effective.
Last Updated: 03 March 2016
Reviewed by Harry Croft, MD