In a comparison of two different diet and two different weight management programs, results of the international PREVIEW intervention study found a low, similar rate of progression to type 2 diabetes (T2D) among people with prediabetes who had initially lost weight on a low-calorie diet (LCD), according to a symposium presentation today titled “PREVIEW Study Results—Prevention of Diabetes through Lifestyle Intervention and Population Studies Around the World” at the American Diabetes Association’s® (ADA’s) 79th Scientific Sessions® at the Moscone Convention Center in San Francisco. The study showed no difference between either of the post-weight loss diet or exercise-management programs, with the participants who had initially lost weight in all groups having a three-year incidence rate of T2D of 4%, which was much lower than anticipated.
In order to identify the most effective lifestyle patterns for the prevention of T2D in a population of people who have prediabetes and are overweight, researchers around the globe began “PREVention of diabetes through lifestyle Intervention and populations studies in Europe and around the World” (PREVIEW). The study’s aim was to determine the effects and interactions of different types of diets and different exercise regimens on the development of new cases of T2D in patients with prediabetes.
“Further work is needed to explore the reasons for such successful prevention of type 2 diabetes, however, it is likely that the initial weight loss combined with thorough education and support in the components in either nutrition plan, in addition to a physical activity program, led to successful lifestyle changes and maintenance of at least some of the initial weight loss in most of the people completing the trial,” said one of the lead investigators Ian Macdonald, BSc, PhD, professor of metabolic physiology at the University of Nottingham. “The inclusion of an initial period of a low-calorie diet achieving significant weight loss, preceding a well-structured and effectively delivered weight maintenance program, may be a major feature of future diabetes prevention programs.”
PREVIEW is, to-date, the largest multi-national trial to address T2D prevention in adults with prediabetes through nutrition and exercise. The study began in 2013 and enrolled 2,223 participants using intervention centers in Denmark, Finland, the United Kingdom, the Netherlands, Spain, Bulgaria, Australia, and New Zealand. The 36-month intervention consisted of two phases: a two-month period of rapid weight reduction achieved using an LCD (800 kcal/day), followed by a 34-month randomized diet and exercise phase for weight loss maintenance consisting of four treatment arms. The impact of a high-protein, low-glycemic index (GI) vs. moderate protein, moderate-GI diet in combination with moderate or high-intensity physical activity on the incidence of T2D and the related clinical end-points were investigated.
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