Early this decade, a large clinical trial showed that after being randomly assigned to follow a healthier diet and exercise more for three years, people at high risk of type 2 diabetes were less likely to develop the disease than people not assigned to make these lifestyle changes. Now a follow-up study demonstrates that the benefits of these changes persisted after 10 years, though the gains were somewhat diminished.
The incidence of diabetes was 34 percent lower in the lifestyle-change group than in the placebo group (compared with a 58 percent reduction after three years). And those who made changes also had better cardiovascular health, based on their blood pressure, triglyceride levels, and use of drugs for heart disease.
The original trial also found a reduced incidence of diabetes (31 percent less) among patients randomly assigned to take the diabetes pill metformin, and the new study found that after 10 years, diabetes was 18 percent lower in the metformin group than in a placebo group.
“The results are very reassuring,’’ said Dr. David Nathan of Massachusetts General Hospital, who chaired the follow-up study. “With these remarkably effective short-term interventions, we saw a persistent long-term effect.’’
The lifestyle change group originally lost about 7 percent of their weight, or 15 pounds, but regained about 10 pounds after 10 years. Their exercise consisted of brisk walking for 30 minutes a day, five days a week.
BOTTOM LINE: People at risk for diabetes who took part in a program to improve their diet and increase physical activity were less likely to develop the disease over a 10-year period than people who didn’t make these lifestyle changes, as were people who took an oral diabetes drug.
CAUTIONS: The results may have been affected by the early ending of a previous phase of the trial, at which point the lifestyle program was offered to all participants.
WHERE TO FIND IT: Lancet, Oct. 29
Antipsychotic drugs tied to weight gain in children
Children and adolescents who have serious mental illnesses such as bipolar disorder, schizophrenia, or mood disorders are increasingly being treated with second-generation antipsychotic drugs. Compared to similar patients not taking the drugs, a new study reports, young people from 4 to 19 years old who were taking them for the first time quickly gained significant amounts of weight. Some patients had other changes that might put them at risk for diabetes and heart problems.Dr. Christopher Correll of Zucker Hillside Hospital in New York led a team of researchers who studied 205 children newly prescribed antipsychotic drugs. After about 10 weeks, their weight increased an average of 13 pounds compared with less than a pound gained in a comparison group. Depending on the drug, 10 percent to 36 percent of the patients crossed the line into the obese or overweight category, based on body mass index. Two drugs, olanzapine and quetiapine, were linked to higher cholesterol and triglyceride levels, which are risk factors for metabolic syndrome.
BOTTOM LINE: Children and adolescents who took antipsychotic medications for the first time rapidly gained weight and in some cases had higher blood pressure, cholesterol, and blood sugar levels than a similar group not on the medications.
CAUTIONS: The study was small and short-term. Because patients were not randomly assigned to take the drugs, the results may have been affected by differences among the patients themselves.
WHERE TO FIND IT: Journal of the American Medical Association, Oct. 28
ELIZABETH COONEY 
