Lifestyle intervention lowers type 2 diabetes odds for men at high genetic risk
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Key takeaways:
- Men with impaired fasting glucose participating in a lifestyle intervention had lower type 2 diabetes risk than controls.
- Lifestyle intervention cut type 2 diabetes risk by 70% for men at high genetic risk.
A lifestyle intervention program composed of a healthy diet and increased physical activity can reduce the risk for type 2 diabetes among men with high genetic risk for the disease, according to trial findings.
In the T2D-GENE trial, men aged 50 to 75 years from Finland with impaired fasting glucose and a low genetic risk or a high genetic risk for type 2 diabetes were recruited to participate in a lifestyle intervention program. Adults in the lifestyle intervention group had a lower risk for developing type 2 diabetes at 3 years than a control group of men who did not participate in the intervention, with an even greater risk reduction seen among men with a high genetic risk for type 2 diabetes.
“Our type 2 diabetes prevention program utilized a group-based approach instead of an individual-based intervention,” Markku Laakso, MD, PhD, a professor of internal medicine at the University of Eastern Finland and Kuopio University Hospital, and colleagues wrote in The Journal of Clinical Endocrinology & Metabolism. “Our results suggest that a group-based approach is efficient in the prevention of type 2 diabetes.”
Men with IFG levels of 100 mg/dL to 124 mg/dL with or without impaired glucose tolerance, an HbA1c of less than 6.5%, a BMI of 25 kg/m2 or higher and a low or high genetic risk score for type 2 diabetes, were eligible for the trial. Researchers recruited 628 men to participate in a lifestyle intervention program with group sessions focused on the importance of eating a healthy diet and physical activity. Researchers also recruited 589 control participants with similar inclusion criteria as the intervention group. The primary outcome was incident type 2 diabetes at 3 years, defined as a fasting plasma glucose of 126 mg/dL or higher, a 2-hour glucose of 200 mg/dL or higher on an oral glucose tolerance test, an HbA1c of 6.5% or higher, or if one was receiving diabetes medication during the follow-up. HbA1c was measured at 1 year and both HbA1c and 2-hour glucose were collected at 2 and 3 years for intervention participants. Men in the control group had HbA1c measured, and an OGTT conducted at 3 years.
The intervention group included 315 men with a low genetic risk for type 2 diabetes and 313 with a high genetic risk for type 2 diabetes. Of the control group, 196 had a low genetic risk score for type 2 diabetes and 149 had a high genetic risk for type 2 diabetes.
Men participating in lifestyle intervention had a lower risk for developing type 2 diabetes at 3 years than those in the control group (HR = 0.48; 95% CI, 0.31-0.75; P = .001). Among men with a high genetic risk for type 2 diabetes at baseline, intervention participants had a 70% lower risk for developing type 2 diabetes at 3 years than men in the control group (HR = 0.3; 95% CI, 0.16-0.56; P < .001). No difference in type 2 diabetes risk was seen between the intervention and control groups among men with a low genetic risk for the disease.
Men in the intervention group lost more weight, had less of an increase in 2-hour glucose and a greater increase in disposition index from baseline to 3 years than the control group. For adults with low genetic risk for type 2 diabetes, those partaking in the intervention had less of an increase in fasting glucose and glucose area under the curve than the control group.
“These findings suggest that participants in both groups benefited from lifestyle intervention, irrespective of the genetic risk,” the researchers wrote.
The researchers concluded all adults with prediabetes should be encouraged to make lifestyle changes.
“A similar lifestyle intervention could be provided for all individuals at risk of type 2 diabetes, independent of the genetic risk, and individualized intervention programs are not justified based on these results,” the researchers wrote. “However, type 2 diabetes is a heterogenous disease, and therefore a precise nutrition approach might be beneficial for some subgroups of type 2 diabetes.”
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