Impact of 3-year lifestyle intervention on postprandial glucose metabolism: the SLIM study

C. Roumen, E. Corpeleijn, E.J.M. Feskens, M. Mensink, W.H. Saris, E.E. Blaak

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    Abstract

    OBJECTIVE: To determine the effect of a 3-year diet and exercise lifestyle intervention, based on general public health recommendations, on glucose tolerance, insulin resistance and metabolic cardiovascular risk factors in Dutch subjects with impaired glucose tolerance (IGT). METHODS: The study was a randomized controlled lifestyle intervention over 3 years. A total of 147 IGT subjects (75 male, 72 female) were randomized to the intervention (INT) group or control (CON) group; 106 subjects (52 INT, 54 CON) completed 3 years of intervention. Annually, glucose, insulin and free fatty acid (FFA) concentrations were determined fasting and after an oral glucose tolerance test. Measurements of body weight, serum lipids, blood pressure and maximal aerobic capacity were also performed. RESULTS: Analysis of those who completed the 3-year trial, showed that the lifestyle intervention improved body weight (INT -1.08 +/- 4.30 kg; CON +0.16 +/- 4.91 kg, P = 0.01), homeostatis model assessment index for insulin resistance and 2-h FFA. Two-hour glucose concentrations improved in the INT group, the difference being most pronounced after 1 year, with a return to baseline values after 3 years, from 8.59 +/- 1.55 to 8.55 +/- 0.34 mm; in contrast, 2-h glucose deteriorated in the CON group-from 8.46 +/- 1.84 to 9.35 +/- 2.50 mm (P = 0.02). In the INT group, diabetes incidence was reduced by 58% (P = 0.025). CONCLUSION: Our lifestyle intervention showed a sustained beneficial effect on 2-h glucose concentrations, insulin resistance and 2-h FFA, even after 3 years. Our lifestyle intervention is effective, but for implementation more information is needed about factors influencing adherence. AD - Department of Human Biology, Nutrition and Toxicology Research Institute Maastricht, NUTRIM, Maastricht University, Maastricht, The Netherlands. cheryl.roumen@hb.unimaas.nl
    Original languageEnglish
    Pages (from-to)597-605
    JournalDiabetic Medicine
    Volume25
    Issue number5
    DOIs
    Publication statusPublished - 1 Jan 2008

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