Lifestyle Change Not Enough for High-Risk Individuals

Each year 36 million people across the globe die of noninfectious diseases such as diabetes, cardiovascular diseases and cancer. Common risk factors for these diseases are physical inactivity and eating too much of the wrong foods, which lead to excess weight and insulin resistance. American, Finnish and German studies have now shown that lifestyle changes with more physical exercise and a healthier diet can successfully lower the incidence rate of these diseases. However, these measures do not work for so-called high-risk individuals. Diabetes experts will discuss the causes for this and the individual preventive measures these people need at the press conference of the 7th Diabetes Autumn Meeting of the German Diabetes Society (DDG) on November 15-16, 2013 in the ICC Berlin.

Several international studies have shown that lifestyle change interventions can prevent nearly half of all new diabetes cases in the first years. “From this it is generally concluded that diabetes – with regard to the population – can be prevented with a healthier lifestyle,” said Professor Andreas Fritsche, MD, board member and spokesperson of the German Diabetes Society and head of the department “Prevention and Therapy of Type 2 Diabetes” at the Institute for Diabetes Research and Metabolic Diseases at University Hospital Tübingen, a partner in the DZD. “This creates the impression that type 2 diabetes is solely a problem of noncompliance and the refusal to take preventive measures.” People with type 2 diabetes are often given the blame for their disease; people assume that the disease is their own fault. In addition, this suggests that drug therapy for type 2 diabetes would no longer be necessary if the affected individuals would just lose enough weight, exercise more and eat differently. “Diabetes is thus often explained to be only a lifestyle disease,” Professor Fritsche warned. However, people with diabetes are dependent on medical treatment and in advanced stages of the disease usually also require drug treatment. Moreover, some individuals are at particular high risk for diabetes independent of their lifestyle and at the same time are not responsive to conventional diabetes prevention measures.
“Providers of prevention measures and physicians must focus more on these individuals who are at high risk and have a high disease burden,” said Fritsche. “They need preventive measures that specifically address their individual disease mechanisms: The slender person with prediabetes requires different preventive measures than overweight individuals. Someone with elevated fasting blood glucose levels has different treatment needs than someone with postprandial elevated blood glucose levels. Furthermore, people with isolated insulin resistance require other measures than those with isolated insulin secretion disorder or elevated liver fat,” Fritsche went on to explain. How to identify high-risk individuals and how to develop personalized preventive measures are the main discussion topics of the German Diabetes Society at the press conference during the 7th Diabetes Autumn Meeting in Berlin on Friday, November 15, 2013.