Effects of a 6‐month trial of weight‐loss diet plus aerobic exercise versus matched (by dose/intensity) exercise alone on glucose tolerance and insulin resistance in subjects with pre‐diabetes (117.2)

The Diabetes Prevention Program first demonstrated benefits of lifestyle interventions for delaying progression of pre‐diabetes. Our study examines the separate effects of a weight‐loss diet plus exercise or exercise alone on oral glucose tolerance (OGTT) in a randomized 6‐mo. study of participants (age=57.8 + 7.6 y; BMI 30.6±2.9) with pre‐diabetes (fasting glucose 95‐124 mg/dL). Weight reduction diet + moderate aerobic exercise (D+Ex; n=41) was compared to a matched exercise program with no diet component (Ex; n=36). Baseline age, BMI, fitness level, and gender/race did not differ. D+Ex included a weekly support group and body weights (BW). Compliance with supervised exercise was similar for D+Ex and Ex (87.8% and 84.2%). At 6 mo., BW reductions in D+Ex (‐6.1 + 5.0 kg) exceeded (p<0.0001) those in Ex (‐0.9±3.3 kg). D+Ex improved (p<0.0001) fasting glucose (‐4.9±8.1 mg/dL), fasting insulin (‐3.5±3.8 mg/dL), 2‐hr glucose (‐20.5±35.9 mg/dL), HOMA‐IR (‐1.0±1.2) and glucose areas under the response curve. Ex, as well as D+Ex, improved (p<0.05) 2‐hr glucose, insulin area under the curve, and Matsuda Index. Weight loss plus exercise was superior for improving glucose tolerance/insulin resistance in this population. Thus, clinical recommendations for prediabetes should emphasize diet‐induced weight loss, along with exercise, as the first line of treatment.Grant Funding Source : Supported by NIDDK R01‐DK081559 and NIA AG000029.