Pre-diabetes and Effects of Weight-loss

Pre-diabetes is extremely prevalent, affecting almost 12 million overweight persons aged 45 to 74 years in the United States.
Weight loss and control are key goals for persons with diabetes. Weight loss improves insulin sensitivity and glycemic control, lipid profiles, blood pressure, mental health, and quality of life; moderate intentional weight loss sustained over time may be associated with reduced mortality. Several large randomized controlled trials have shown that weight loss is a vital management strategy for overweight persons with pre-diabetes, as it may delay or prevent the progression to clinically defined type 2 diabetes.
The American Diabetes Association’s recent position statement recommends that “individuals at high risk for developing diabetes need to become aware of the benefits of modest weight loss and participating in regular physical activity."

Long-term effectiveness of weight-loss interventions in adults with pre-diabetes
This particular study assessed the effectiveness of weight-loss and weight-control interventions for adults with pre-diabetes. Computerized searches were conducted of multiple electronic databases up to August 2003 and randomized controlled trials were selected. These trials examined weight-loss or weight-control strategies using at least one dietary, physical activity, or behavioral intervention, and included a follow-up interval of 12 months. Effects were combined using a random effects model.
Overall, weight-loss strategies using dietary, physical activity, or behavioral interventions produced significant improvements in weight among persons with pre-diabetes, and a significant decrease in diabetes incidence. Substantial improvements were noted in the few studies that examined glycemic control, blood pressure, and lipid concentrations. The incidence of diabetes was significantly lower in the intervention groups versus the controls in three of five studies examining this outcome at 3 to 6 years follow-up. Yet further work is needed on the long-term effects of these interventions on morbidity and mortality and on how to implement these interventions in the community setting, a problem often faced when trying to bring lasting effects through public health programs.