Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Practice Guideline: Preventing Type 2 Diabetes

Combining physical activity with diet most effective

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The Community Preventive Services Task Force’s new recommendation for combined diet and physical activity promotion programs for the prevention of diabetes includes programs by health care systems, communities, and other implementers to provide counseling and support to clients at risk for type 2 diabetes.

The recommendations are based on a systematic review of 53 studies that evaluated 66 programs, which found compared with usual care, diet and physical activity promotion programs:

• reduced type 2 diabetes incidence: risk ratio (RR), 0.59

• decreased body weight by 2.2%

• reduced fasting blood glucose by 2.2 mg/dL

• improved other cardiometabolic risk factors

Citation: Balk EM, Earley A, Raman G, Avendano EA, Pittas AG, Remington PL. Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Ann Intern Med. 2015. doi: 10.7326/M15-0452.

Pronk NP, Remington PL. Combined diet and physical activity promotion programs for prevention of diabetes: Community preventive services task force recommendation statement. Ann Intern Med. 2015. doi: 10.7326/M15-1029.

Commentary: Obesity and diabetes have become the critical health issue of the millennium. According to current projections, of every child born this year, one in three will develop diabetes during his or her lifetime1. This systematic review shows that there is hope – that the optimal approach to stemming the tidal wave of diabetes is going to be a two-pronged approach: 1) To increase healthy behaviors population- wide in order to avoid the development of obesity and diabetes, and; 2) To provide comprehensive combined diet and physical activity promotion programs to help people with pre-diabetes decrease their risk of developing diabetes by up to almost 70%. —Neil Skolnik, MD

1. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and pre-diabetes prevalence. Popul Health Metr. 2010;8:29.

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