Interventions: New studies in diabetes prevention
If you've seen Jamie Oliver's Food Revolution on ABC, you might be interested in some recent studies about group and individual interventions for people who are overweight or at risk for diabetes.
Dr. William C. Knowler presented the findings of his research related to diabetes to the USC/California Endowment National Health Journalism Fellows. Some takeaways: Preventive behavior should begin early for people with genetic susceptibility to diabetes. One reason to intervene early, is that diabetic pregnant moms are much more likely to have large babies who are later more likely to develop diabetes. It becomes a vicious cycle when these babies grow up, develop diabetes and get pregnant themselves.
In fact, Knowler found that in the group he studied, two-thirds of children with diabetic mothers developed diabetes by their early 20s. So, the younger we can intervene -- preferably before pregnancy -- the better. The good news is that it is never too late to change your lifestyle to help prevent disease. Knowler found that lifestyle intervention can greatly reduce both obesity, diabetes risk factors, and the eventual development of the disease. Weight loss and exercise alone might be even more effective prevention than medication. But medication should not be discounted. New diabetes drugs have improved diabetes treatment significantly, greatly reducing the number of people whose diabetes progresses to end stage renal disease.
You can get more detailed information about his research from the Diabetes Prevention Program Study Repository. Here is a recent post about culture clashes and the importance of differentiating between Type 1 and Type 2 diabetes.
Dr. Francine Kaufman turned to interventions for groups, rather than individuals. "When I started my career," said Kaufman, "we did not see Type 2 diabetes in youth." Now, "clinics like mine are overwhelmed." You can read more about her large-scale study, HEALTHY, in the New England Journal of Medicine. Her book, Diabesity, chronicles startling statistics, stories and outcomes due to diabetes and obesity in America. You can also read more about Kaufman's work in a post about a past talk at the Fellowships.
The study has sparked serious debate in the public health world: Kaufman went into schools, and worked with kids to try to reduce their weight, body mass index (BMI) and waist size. Her research group compared those children with children in schools that didn't receive health interventions but were involved in data collection. Interestingly, both groups of kids lost weight! But, what is the take home message? While Kaufman was conducting her study, larger reforms were going on nationwide that were making a lot of the same changes in schools that she was attempting to make with her research. We know that kids lost weight, which reduces their risk factors for all kinds of disease and disability -- clearly a good thing. But we might not need a large-scale private intervention to replicate their results.
Need help understanding p-values and statistical significance? Check out a previous post, "Writing about p-values without embarrassing yourself."
Hat tip to Angilee Shah for helping with this post.