| Abstract: |
Weight loss and increase physical exercise reduce the risk for diabetes in people with impaired glucose tolerance (IGT), however evidence on the effects of these interventions on people without IGT is lacking. This article reports on a study undertaken to examine the influence of a comprehensive intervention program on the risk for developing diabetes in men without IGT and in a post hoc subgroup analysis by baseline cigarette smoking status. The study included 12,866 men aged 35 to 57 years, at risk for cardiovascular disease, who were randomly assigned to either a special intervention or usual care group and followed for 6 to 7 years. This article reports on 11,827 men from this group who were without diabetes or IGT at entry and for whom follow-up glucose measurements were available. Men in the special intervention group were counseled to change diet (reduce saturated fat, cholesterol, and calorie intake), to stop smoking, and to increase physical activity. Blood pressure was treated more intensively in the special intervention group than in the usual care group. Results showed that 11.5 percent of the special intervention group and 10.8 percent of the usual care group developed diabetes over 6 years of follow-up. The authors conclude that weight gain after smoking cessation and the use of antihypertensive drugs may have counterbalanced the beneficial effect of the lifestyle intervention for the special intervention group smokers, while the lifestyle intervention was beneficial among nonsmokers. 1 figure. 5 tables. 52 references. |