Study shows lifestyle changes work best in fighting diabetes


POSTED: Friday, October 30, 2009

A fishery scientist who is one of 60 isle participants in a 10-year national study on diabetes prevention said he lost weight and has better health because of it.

“;I feel incredibly privileged to be in this,”; said Pierre Kleiber, of St. Louis Heights, who is with the National Marine Fisheries Service.

He started out with a group taking the generic anti-diabetic drug metformin but ended up with lifestyle intervention as well for a “;double-barrel effect,”; he said.

It was clear, less than three years into the study, that diet and exercise were the most significant factors in preventing type 2 diabetes, said Dr. Richard Arakaki, principal investigator for Hawaii's Diabetes Prevention Program.

The incidence of diabetes was reduced by 58 percent with intensive lifestyle changes and 31 percent with the anti-diabetic drug metformin, compared with a placebo, he said.

So results after 10 years, reported yesterday in the medical journal Lancet, are not a complete surprise.

The diabetes rate was reduced by 34 percent in a group with lifestyle changes and 18 percent in a group treated with metformin, compared with a group receiving a placebo.

;[Preview]  UH Diabetes Study

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“;It's a remarkable and landmark study that has tremendous public health implications and shows dedication and commitment by the volunteers,”; said Arakaki, professor of medicine in the University of Hawaii John A. Burns School of Medicine.

About 104,000 Isle residents have been diagnosed with diabetes, and an estimated 39,000 are undiagnosed, according to the American Diabetes Association.

Reducing the difficult and costly disease would also reduce the economic and health burden for the state, Arakaki said.

He said the first Hawaii volunteer was signed up for the prevention study in 1996, and after three years of recruitment, 74 people were participating locally with a total of 2,766 nationally.

About 75 percent of the Hawaii participants are Asians and Pacific Islanders, many over age 60, he said.

Participants were divided into three groups—one making lifestyle changes, another treated with metformin and the third given a placebo.


Kleiber, 65, said his doctor recommended that he volunteer for the study because of neuropathy (tingling or numbness) in his feet, which could be an early sign of diabetes.

He said the addition of lifestyle changes to the twice-daily metformin was easy for him because he used to be a rock climber and has always been active.

His wife, Nancy, joined him in walking 30 minutes to an hour every morning, and they watch their diet, he said. His weight dropped to 160 pounds from 190.

“;I will continue as long as this program goes,”; he said. “;I'm delighted with it.”;

He said program coordinator Mae Isonaga has frequent functions and get-togethers to maintain the participants' interest.

Arakaki said the study will continue at least five more years, with about $200,000 per year for the Hawaii program from the National Diabetes Institute.

Researchers will follow the participants to look for heart disease, stroke and other risk factors.

“;It is a very important issue, and now we have a cohort of diabetics (35 percent) and nondiabetics,”; he said. “;We have the earliest diagnosed diabetic population in the nation.”;

They will be examined for changes in the eyes and other complications, including cognitive function, he said.

Researchers also are interested in learning whether metformin (which decreases the liver's glucose production and lowers plasma glucose levels) has a long-term effect in preventing diabetes, Arakaki said.