Something we've known but science is just starting to "prove":

A recent meta-analysis published in the British Medical Journal consolidated the evidence from 17 clinical trials that studied the effects of lifestyle, drugs and other methods on men and women with impaired glucose tolerance. Results showed that intervention can reduce the risk of type 2 diabetes in high risk individuals, and lifestyle changes seem to be at least as effective as drug therapy. Compared to individuals who received standard advice only, the effect of lifestyle changes resulted in a 49 percent reduction in the risk of developing diabetes. Exercise alone or exercise combined with a healthier diet was more effective than diet alone. Oral diabetic medications were also effective in delaying or preventing diabetes, but were not as effective as lifestyle changes. Orlistat, an anti-obesity drug, was also effective in reducing risk when compared to control groups.

Although both medications and lifestyle changes were effective in reducing the risk of diabetes, diet and exercise were associated with considerably fewer adverse effects than those caused by pharmaceuticals, which were typically gastrointestinal effects and reduced liver function. Since it is fundamentally a lifestyle issue, the authors had concerns about the practice of treatment with a lifelong course of medication, especially since even minor adverse effects become more significant if a medication is to be taken for life. But they also noted that compliance is generally the key when it comes to lifestyle interventions, so strategies to improve compliance need to be enhanced and put into action.

BMJ. 2007 Jan 19; (Epub ahead of print)

More effective I'd say.. I'm not really a fan of meta-analysis, but this is definitely an article that the fat masses need to take to heart.

I know from experience lifestyle changes work with diabetes. Before I changed my diet and got my training in gear, I was diagnosed with non insulin dependent diabetes, and I had the often-accompanying problems (e.g. BMI in the "obese" range, and raised blood pressure, LDL and triglycerides). After FOUR MONTHS of my lifestyle change (yes, FOUR MONTHS) my glycaemic control was well controlled and those other measurements all normal. My triglycerides were reduced by 67%. Six months further still, and my glycaemic control was near normal and my LDL and tris were optimal (and my HDL , which had begun on the low side of normal, was slightly improved). Within a year, everything was better still, to the point where my diabetes is basically not detectable (if I had blood tests as a new, unknown pateient, tomorrow, I'd have a clean bill of health with better than average measurements).

A few days ago I had a consultation with an endocrinologist, and he said that my "official" status as a diabetic was, indeed, now in question.

I've never had medication for diabetes.

diet and exercise were associated with considerably fewer adverse effects than those caused by pharmaceuticals

Brilliant!

There is a new study that claims most patients diagnosed with diabetes fail to follow their doctor's advice to exercise:

http://www.webmd.com/content/Article/131/118102.htm?pagenumber=1

Only 39% of surveyed adults with diabetes engaged in regular physical activity, compared with 58% of adults who did not have the disease... activity levels declined as risk factors for type 2 diabetes increased.:(

There is a new study that claims most patients diagnosed with diabetes fail to follow their doctor's advice to exercise:

http://www.webmd.com/content/Article/131/118102.htm?pagenumber=1

:(

Yeah my first thought on reading Jeremy's post was "well duh, but most people don't do the lifestyle change." The diet part is quite nasty to actually do, there is a ton of recent work showing that you are not in complete control of what you eat.

I think the exercise part is tough because people don't get good advice on just what exercise is, how it works, how to do it, and how to choose the components of the program.

It's not necessarily as clearcut as that.

My turning point (and it was a rapid and painless one once implemented) came when I finally REJECTED the official medical advice that had been given to me. That advice consisted of: eat as little fat as possible, make carbs as high a percentage of EVERY meal as possible (especially "complex carbs" like pasta), don't each much fruit. Vegetables was an optional extra. Exercise, while undefined, was also an optional extra. Protein wasn't mentioned as part of a healthy diet - it was mentioned only in warnings not to eat too much of it.

There were no different kinds of fat, no fibre, no vitamins and minerals or other healthy food components. And no calories, no energy balance concept.

I struggled with the above comprehensive lifestyle plan for something like two years, while I got fatter, iller, and more disabled. I became fatalistic about it, which isn't surprising, since alll indications were that my condition was just that, fatal. Then (with my wife's encouragement) I decided to step outside the territory defined by my doctor and the NHS Dietician, and join a gym and do well structured exercise of some kind with a trainer. I quickly gained aerobic fitness, as well as confidence and new aspirations of good health. However, my only dietary guideline was the one earlier given to me, and my blood tests were getting worse and my weight not changing enough.

After a year of that, my desire to shed my fat and also take control of my health reached a combustable level, and at that exact moment I found this forum - I put more of my energy into the resistance training side of exercise and abandoned my previous useless dietary concepts in favour of sounder ones. At that point, my health reversed - within 4 months, my lipids, glycaemic control and blood pressure were normal, and after a little more time I started to see (and to target) "optimal" readings.

The turning point was in part a psychological tunring point, yes, but those psychological flames were fueled by information and inspiration. For this reason, I don't feel I could ever assume that a person is simply non-compliant.

While exercise is extremely important, diet can play a bigger role sometimes. December2006 edition of Men's Health has an article the cure for diabetes p136 that presents the diet that works. A diet that has been known for years to work. One that is nearly completely opposite to What most doctors and clinics suggest to diabetics.

You wonder why? Anyone with or worried they might have the disease should read the article. It in a few words says high protein, high fat, low carb diet will do the job.:tucool:

While exercise is extremely important, diet can play a bigger role sometimes.

Diet is really powerful but it's quite hard for a lot of people to use it effectively over many years. Usually diet gains are reversed within a couple years of success. There is some evidence that things get worse after failed diets than if there had been no diet at all.

So I'm not saying that diet doesn't work - I'm saying that there's a lot of people that do not succeed with diet, because it's actually quite difficult.

The other thing about exercise is that HDL cholesterol is not available in any dietary source. You can't eat it. If you want to elevate your HDL level, (and this is normally one big thing in this metabolic syndrome type of picture), then you must exercise. Diet can't do it all.

Like Philph, I also "beat" diabetes by changing my lifestyle from a diet and exercise standpoint. I refused to go onto the medications that were recommended, and realized very quickly that the diet they recommended was far too similar to the one that got me to the point of being overweight and unhealthy to begin with. On my last visit to the doctor, he gave me a clean bill of health, and said that as long as I maintained my current lifestyle, I should no longer consider myself to be a diabetic.