Comparison of the Effectiveness of Lifestyle Modification with Other Treatments on the Incidence of Type 2 Diabetes in People at High Risk: A Network Meta-Analysis (2019)
Objective: This meta-analysis aimed to assess the effectiveness of lifestyle modifications compared to other treatments in preventing the onset of type 2 diabetes in high-risk individuals. The primary question addressed whether lifestyle modification programs are more effective in this regard than alternative treatments.
Methodology: The study considered interventions such as lifestyle changes, dietary modifications, exercise, or medications (orlistat, metformin, acarbose, voglibose, pioglitazone, rosiglitazone, pitavastatin, glipizide, and herbal medications). Control groups received standard education or usual treatment. Specific dietary programs, including the Mediterranean diet, were categorized separately. Participants in the selected studies were adults identified as high-risk for type 2 diabetes based on criteria such as elevated 2-hour plasma glucose levels, impaired fasting glycaemia, or impaired glucose tolerance.
Results: The odds ratio for the onset of type 2 diabetes in the lifestyle modification group was approximately 0.60 (frequentist approach) and 0.46 (Bayesian approach) compared to the standard intervention group. Indirect comparisons between lifestyle modification and other treatments did not show significant variations. The SUCRA analysis indicated that interventions with a higher rank in terms of effectiveness were exercise and lifestyle modification, along with orlistat and glipizide.
Discussion: The meta-analysis provides evidence supporting the effectiveness of lifestyle modification in reducing the incidence of type 2 diabetes in high-risk individuals when compared to standard treatment or placebo, as well as other interventions. The intervention group exhibited approximately half the rate of diabetes onset compared to control groups. Although indirect comparisons yielded varied and nonsignificant results, lifestyle modification demonstrated stronger effects compared to standard or placebo interventions, as supported by SUCRA rankings.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627198/#app1-nutrients-11-01373
