Behavioral interventions to prevent progression to diabetes equally effective in men and women

November 27, 2014

Behavioural and drug interventions aiming to prevent people with prediabetes progressing to full blown type 2 diabetes are equally effective for both sexes at preventing progression and reducing weight, according to a new systematic review and meta-analysis. The research is by Dr Anna Glechner, Danube University Krems, Austria, and Dr Jürgen Harreiter, Medical University of Vienna, Austria, and colleagues.

Prediabetes is a general term that refers to an intermediate stage between normal blood glucose control (normoglycaemia) and type 2 diabetes (high blood glucose levels/poor control). It includes individuals with impaired glucose tolerance (IGT), impaired fasting glucose (IFG) and a combination of the two.

Early detection of prediabetes offers the possibility of using lifestyle or pharmacological interventions to prevent or slow the progression to type 2 diabetes. Numerous studies provide evidence that lifestyle interventions such as changes in diet and regular physical activity, or oral glucose-lowering drugs, can delay or prevent the onset of type 2 diabetes in people with prediabetes.

In this new analysis, the authors searched for studies between 1980 and 2013 that explored sex-specific differences in treatment effects, and found 12 studies that matched their criteria. If published studies did not provide enough detail, they contacted authors to release unpublished data on sex-specific differences. Compared with usual care, men and women who received lifestyle interventions (including diet and exercise) were 40% less likely to progress to type 2 diabetes after 1 year; and 37% less likely to progress after 3 years.

People involved in lifestyle interventions also experienced greater weight reductions (mean increased weight loss 2.45 kg after 3 years versus usual care), and greater reductions of fasting plasma glucose (−0.31 mmol/l greater after 3 years versus usual care). No statistically significant differences in treatment effects between men and women were apparent for any outcomes.

Overall, no differences in the preventive effect of therapies with oral glucose-lowering agents between men and women could be detected. However, the intake of oral glucose-lowering drugs was associated with a reduction of type 2 diabetes.

The authors say: "To the best of our knowledge, this is the first systematic review that assessed potential sex-specific differences in effects of preventive interventions in prediabetic people. Overall, based on data from more than 5,500 men and 7,400 women, our review did not find any relevant sex-specific differences in treatment effects during 1 to 6 years of active interventions. In both sexes, lifestyle and pharmacological interventions had a beneficial preventive effect on the incidence of type 2 diabetes and weight gain."

They add: "Clinically, these findings highlight an important issue. Despite differences in age of onset, detection and burden of type 2 diabetes between men and women, the effectiveness of preventive interventions in people with prediabetes is not influenced by gender. Consequently, clinicians and prevention managers can focus on factors that are known to determine the magnitude of beneficial effects, such as adherence. Clinicians also need to focus on other aspects of sex-disparities such as the higher incidence of type 2 diabetes in middle-aged men and gaps in the quality of care between diabetic men and women."

Successful prevention of diabetes also, say the authors, has an economic impact. They say: "Recent cost-effectiveness analyses indicate that lifestyle interventions are the most cost-effective approach. In people with prediabetes who are not able to adhere to lifestyle changes, initiation of metformin is probably the next best option, but thus far, no trial evidence confirms this for non-responders to lifestyle interventions."
-end-


Diabetologia

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.