Preventing the Onset of Diabetes: No Case for Nihilism

The Community Prevention Services Taskforce in the US commissioned an evidence review of the effectiveness of programmes to promote exercise and weight loss on prevention of diabetes.[1] The headline message is that programmes targeting both weight loss and exercise are effective at reducing the onset of diabetes by about 40% over a three to six year period. Intensive programmes are more effective than less intensive ones. The diet/exercise programmes also resulted in improvement in blood fats and systolic blood pressure. The literature is extensive – 53 studies in all, and there was no evidence of publication bias on Egger’s test.[2] We will discuss health economic analysis of the intervention in a forthcoming news blog.[3]

— Richard Lilford, CLAHRC WM Director


  1. Balk E, Earley A, Raman G, Avendano EA, Pittas AG, Remington PL. Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among Persons at Increased Risk: A Systematic Review for the Community Preventative Services Task Force. Ann Intern Med. 2015; 163(6): 437-51.
  2. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109): 629-34.
  3. Li R, Qu S, Zhang P, et al. Economic evaluation of combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Ann Intern Med. 2015; 163: 452-60.

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