Can Diabetes Be Prevented in Older Adults?

42-15653241A study published yesterday supports the idea that even in older adults, over 65, type 2 diabetes can be prevented in most cases by healthy lifestyle choices.

Researchers examined the participants in the Cardiovascular Health Study – 4,883 men and women over 65 at baseline – over the course of 10 years.  Median age at enrollment was 73.  Participants were followed clinically for 10 years.  New cases of diabetes over 10 years: 337.  Researchers suspected, based on previous studies in younger folks, that a reduced incidence of diabetes onset would be related to:

  • physical activity levels above the median (half of people exercise less than the median, half exercise more)
  • never smoking, or minimal and years ago
  • “healthy diet,” defined as high fiber, low glycemic index foods, lower trans fats, higher polyunsaturated-to-saturated fat ratio
  • low body mass index (not overweight)
  • waist circumference under 92 cm (36.2 inches) for men and 88 cm (34.6 inches) for women
  • low to moderate alcohol use

We’ll call these “lifestyle factors.”  Participants were analyzed to see how well they fit this profile and whether or not they developed diabetes.

Results

The more each of these lifestyle factors characterized a person, the lower the risk of developing diabetes.

High physical activity and healthy diet by themselves reduced risk of diabetes by half.

Study authors estimate that healthy lifestyle choices could prevent eight or nine out of 10 cases of diabetes in older adults.

Take-Home Point

The researchers rightfully point out that their results are associations, not proof that these lifestyle factors prevent diabetes.  Given the totality of the evidence from this and other studies, I would adopt many of the low-risk lifestyle choices if I wanted to avoid diabetes.

Steve Parker, M.D.

Reference:  Mozaffarian, D., et al.  Lifestyle risk factors and new-onset diabetes mellitus in older adultsArchives of Internal Medicine, 169, (2009): 798-807.

Update April 30, 2009:

Research in younger populations has associated the following factors with prevention of type 2 diabetes:

  1. Avoid overweight, or lose weight if you are overweight (body mass index over 25)
  2. Regular physical activity
  3. Don’t start smoking, or quit if you do
  4. Pick the right parents

Some cases of diabetes are related to genetic factors beyond our control.  Having parents or close relatives with diabetes suggests that you may be genetically predisposed.  Genetics is not necessarily destiny, however.

-Steve

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