Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males

Kosáka, Kinori; Noda, Mitsuhiko; Kuzuya, Tsunehiko

doi:10.1016/j.diabres.2004.06.010

Cited by 544 publications

(386 citation statements)

References 36 publications

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“…In the Diabetes Prevention Program, reversion to normoglycaemia occurred in almost 20% of IGT subjects even without lifestyle intervention [23]. Our regression rate of 39.7% was comparable to that reported for Japanese (33.9% in the absence of lifestyle intervention) [24], but it remains possible that the phenomenon of regression to the mean might contribute to the regression rate [25]. Even though we depended on a single OGTT at each time point to determine the glycaemic status, the change in glycaemic status was probably genuine as the risk of persistent hyperglycaemia was also predicted by well-accepted baseline risk factors, such as high BMI and fasting glucose.…”

Section: Discussionsupporting

confidence: 78%

Polymorphisms of the gene encoding adiponectin and glycaemic outcome of Chinese subjects with impaired glucose tolerance: a 5-year follow-up study

et al. 2006

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Aims/hypothesis Polymorphisms of the gene encoding adiponectin (ADIPOQ) have previously been associated with type 2 diabetes in Europid and Japanese subjects, but not in Pima Indians. The aim of this study was to determine the contribution made by ADIPOQ gene variants to glycaemic status in southern Chinese individuals. Subjects and methods Sixty unrelated subjects were screened for single-nucleotide polymorphisms (SNPs) in the ADIPOQ gene by direct sequencing. The association of tagging SNPs with the outcome of glycaemic status in 262 subjects with impaired glucose tolerance (IGT) was examined in a 5-year prospective study. Results We identified 15 polymorphisms in the ADIPOQ gene, ten of them constituting the tagging SNPs. At 5 years, 39.7% of the subjects with IGT had regressed to NGT, 41.2% had persistent IGT or impaired fasting glucose and 19.1% had developed diabetes. Only the T45G polymorphism was associated with persistent hyperglycaemia at 5 years (p=0.001). Haplotypes formed by the addition of other SNPs, as haplotype blocks or pairs, did not confer greater association than T45G alone. On logistic regression analysis, T45G independently predicted persistent hyperglycaemia at 5 years (OR=2.25, 95% CI 1.29-3.95, G carriers vs TT; p=0.005). It also predicted persistent hyperglycaemia in a nested case-control study involving 158 sex-and age-matched controls with persistent NGT (p=0.012, adjusted for BMI), and that of diabetes or glycaemia progression (p<0.05) in a meta-analysis that also included two published studies in Europid subjects. Conclusions/interpretation Our findings support a significant role of this common ADIPOQ gene polymorphism in predicting glycaemic status in southern Chinese people.

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Section: Discussionsupporting

confidence: 78%

Polymorphisms of the gene encoding adiponectin and glycaemic outcome of Chinese subjects with impaired glucose tolerance: a 5-year follow-up study

et al. 2006

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“…The efficacy of lifestyle modification in preventing the deterioration of impaired glucose tolerance (IGT) to type 2 diabetes is proven [1][2][3][4][5]. Insulin sensitisers such as metformin [3,4] and the glitazones [6,7] have also been useful in the primary prevention of diabetes in people with IGT and in women with a history of gestational diabetes (GDM) [8,9], in different ethnic groups.…”

Section: Introductionmentioning

confidence: 99%

Pioglitazone does not enhance the effectiveness of lifestyle modification in preventing conversion of impaired glucose tolerance to diabetes in Asian Indians: results of the Indian Diabetes Prevention Programme-2 (IDPP-2)

et al. 2009

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Aims/hypothesis The objective of this prevention programme was to study whether combining pioglitazone with lifestyle modification would enhance the efficacy of lifestyle modification in preventing type 2 diabetes in Asian Indians with impaired glucose tolerance. Methods In a community-based, placebo-controlled 3 year prospective study, 407 participants with impaired glucose tolerance (mean age 45.3±6.2 years, mean BMI 25.9± 3.3 kg/m 2 ) were sequentially grouped to receive either: lifestyle modification plus pioglitazone, 30 mg (n=204) or lifestyle modification plus placebo (n=203). The participants and investigators were blinded to the assignment. The primary outcome was development of diabetes. Results At baseline, both groups had similar demographic, anthropometric and biochemical characteristics. At year 3, the response rate was 90.2%. The cumulative incidence of diabetes was 29.8% with pioglitazone and 31.6% with placebo (unadjusted HR 1.084 [95% CI 0.753-1.560], p=0.665). Normoglycaemia was achieved in 40.9% and 32.3% of participants receiving pioglitazone and placebo, respectively (p=0.109). In pioglitazone group, two deaths and two nonfatal hospitalisations occurred due to cardiac problems; in the placebo group there were two occurrences of cardiac disease. Conclusions/interpretation Despite good adherence to lifestyle modification and drug therapy, no additional effect of pioglitazone was seen above that achieved with placebo. The effectiveness of the intervention in both groups was comparable with that of lifestyle modification alone, as reported from the Indian Diabetes Prevention Programme-1. The results are at variance with studies that showed significant relative risk reduction in conversion to diabetes with pioglitazone in Americans with IGT. An ethnicity-related difference in the action of pioglitazone in non-diabetic participants may be one explanation.

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“…In high-risk screened individuals in general practice we have shown that progression rates to diabetes within the first year are high for both IFG and IGT individuals [1]. Evidence on the risk of developing diabetes in these individuals is essential, as progression to diabetes is preventable with lifestyle changes or pharmacological interventions, at least for persons with IGT [2][3][4][5][6][7][8][9]. By knowing which risk factors or changes in risk factor levels determine progression to diabetes, we may be able to develop individualised focused interventions.…”

Section: Introductionmentioning

confidence: 99%

Determinants of progression from impaired fasting glucose and impaired glucose tolerance to diabetes in a high-risk screened population: 3 year follow-up in the ADDITION study, Denmark

et al. 2007

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Aims/hypothesis We sought to identify determinants of progression from impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) to diabetes in high-risk screened individuals. Methods In general practices in Denmark, stepwise screening for type 2 diabetes mellitus in persons aged 40 to 69 years included a risk questionnaire, random blood glucose, HbA 1c , fasting blood glucose and an OGTT. The 1,821 individuals with IGT or isolated IFG (WHO 1999) were re-invited after 1 and 3 years. Follow-up data on glucose measurements were available in 1,510 individuals and additional clinical data in 1,002 collected at the 3-year visits. Regression models using interval censoring were used. Results Progression rates from IFG and IGT to diabetes over 3.5 years were 11.8 and 17.0 per 100 person-years, respectively and were particularly high in the first year. Conclusions/interpretation Higher levels of glucose measures, larger BMI, known hypertension and hypertriacylglycerolaemia are significant determinants of progression in high-risk screened individuals. Weight loss of 1 kg/year or reduction of hypertriacylglycerolaemia markedly reduced the risk of diabetes.

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Prevention of type 2 diabetes by lifestyle intervention: a Japanese trial in IGT males

Cited by 544 publications

References 36 publications

Polymorphisms of the gene encoding adiponectin and glycaemic outcome of Chinese subjects with impaired glucose tolerance: a 5-year follow-up study

Polymorphisms of the gene encoding adiponectin and glycaemic outcome of Chinese subjects with impaired glucose tolerance: a 5-year follow-up study

Pioglitazone does not enhance the effectiveness of lifestyle modification in preventing conversion of impaired glucose tolerance to diabetes in Asian Indians: results of the Indian Diabetes Prevention Programme-2 (IDPP-2)

Determinants of progression from impaired fasting glucose and impaired glucose tolerance to diabetes in a high-risk screened population: 3 year follow-up in the ADDITION study, Denmark

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