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Abstract
To investigate the effectiveness of an intensive diet and exercise program for controlling
non-insulin-dependent diabetes mellitus (NIDDM) and reducing risk factors associated
with macrovascular complications.
Medical charts obtained from 4,587 participants in a lifestyle modification program
were screened for patients with NIDDM. A total of 652 patients was identified, and
their responses to the 3-week program were analyzed.
Fasting glucose level was reduced from 10.0 to 8.45 mmol/l, and 71% of 197 subjects
taking oral hypoglycemic agents and 39% of 212 taking insulin were able to discontinue
their medication. Of the 243 not taking medication, 76% reduced their fasting glucose
levels to < or = 7.84 mmol/l. Blood pressure was significantly reduced, and of the
319 initially taking antihypertension drugs, 34% had their medication discontinued.
Serum total and low-density lipoprotein cholesterol were reduced by 22% and triglycerides
by 33%. The ratio of total to high-density lipoprotein cholesterol was reduced by
13%.
Lifestyle modification consisting of diet combined with aerobic exercise can be effective
for controlling NIDDM and reducing risk factors associated with macrovascular complications
in both men and women. The program was far more effective in controlling the disease
in patients taking no medication or oral agents compared with patients taking insulin.
These results stress the need for early emphasis on lifestyle modification in the
treatment of NIDDM.