Effectiveness of a short-time lifestyle-modification program in normalizing impaired plasma glucose independent of body-weight loss in overweight adults

The estimated cost of DM2 to the Brazilian economy is U$3.9 billion a year largely due to hospitalizations (US$ 243.9 million). There are no published data on the costs of oral agents. As an alternative to drugs, lifestyle intervention can prevent or delay DM2 onset. PURPOSE: To evaluate the short-term effectiveness of a feasible low-cost lifestyle change program (LISC) on overweight subjects with impaired fasting glucose (IFG). METHODS: Eighty adult (>40 yrs) subjects presenting with IFG, under no medication, agreed to participate in a 6 mo. lifestyle change program (LISC) composed of daily sessions (80 minutes) of aerobic physical exercise (40 minutes brisk walking) with dietary counseling. A control normoglycemic group (G1, n=40) following the LISC was matched by age, gender and BMI with the other hyperglycemic groups. The hyperglycemic subjects were divided into two groups: intervention (G2, n=38) that effectively participated in exercise (≥ 3x/wk) and non-exercised controls (G3, n=42). The evaluation included anthropometry, fasting glucose and VO2max. All measurements were undertaken at baseline, three (M1) and six months (M2) after commencing LISC. Statistical analysis utilized Student's t test, ANOVA and Friedman ANOVA-Dunn test. RESULTS: At baseline, the three groups were similar with respect to age, gender, body composition and aerobic fitness (VO2max). In G3 these variables remained stable throughout the experiment whereas G2 showed reduced plasma fasting glucose at M1 (P<0.01) and M2 (P<0.001). At M2 the VO2max had increased significantly (P<0.05), for G1 and G2. The prevalence of IFG at M2 was reduced by 60.5% (P<0.001) in G2 50% of which ≥ 126 mg/dL. CONCLUSIONS: Despite no changes in body fat composition, 6 months of LISC (costing US$6.000) reduced the prevalence of IFG that would save U$8.2 to 97.5 million for the national public health system if applied nationwide. Financial support: FAPESP and CNPq.