Weight loss may be key to preventing type 2 diabetes, researchers say

People with pre-diabetes who lose roughly 10 percent of their body weight within six months of diagnosis dramatically reduce their risk of developing type 2 diabetes over the next three years, according to results of research led by Johns Hopkins scientists.

The findings, investigators say, offer patients and physicians a guide to how short-term behavior change may affect long-term health.

"We have known for some time that the greater the weight loss, the lower your risk of diabetes," says study leader Nisa Maruthur, an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "Now we understand that we can see much of the benefit of losing that weight in those first six months when people are adjusting to a new way to eating and exercising. Substantial weight loss in the short term clearly should go a long way toward preventing diabetes."

Patients with pre-diabetes have blood sugar levels higher than normal but not yet high enough to be classified as type 2 diabetes. Although not all people with pre-diabetes develop full-blown type 2 disease, without intervention the risk of getting it within 10 years is substantially increased and damage to health may already have begun.

Preventing pre-diabetes from becoming full-blown diabetes is critical, Maruthur says. Uncontrolled diabetes—marked by excess sugar in the blood—can lead to eye, kidney, and nerve damage, as well as cardiovascular disease. The new research suggests that if people with pre-diabetes don't lose enough weight in those first months, physicians may want to consider more aggressive treatment, such as adding a medication to push blood sugar levels lower.

Maruthur and her colleagues based their conclusions on analysis of data from the Diabetes Prevention Program (DPP), the largest diabetes prevention study in the United States. A report on the research is published online today in the Journal of General Internal Medicine.

Other Johns Hopkins researchers involved in the study include Frederick L. Brancati, an internationally recognized expert on the epidemiology and prevention of type 2 diabetes who died in May at age 53, and Jeanne M. Clark.