Diabetes Prevention Study Reveals Another Benefit of Lifestyle Changes Treatment with metformin lowered the chances of developing diabetes by 31 percent. …
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National Institute of Diabetes and Digestive and Kidney Diseases NIDDK |
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| |Weight Loss Improves Bladder Control in Women with
Prediabetes |
| |Diabetes Prevention Study Reveals Another Benefit of Lifestyle |
| |Changes |
| |Losing a modest amount of weight through dietary changes and |
| |increased physical activity reduces the occurrence of urinary |
| |incontinence UI in women with prediabetes, a condition in which|
| |blood glucose levels are higher than normal but not yet diabetic|
| |This finding comes from a new study, published in the February |
| |issue of Diabetes Care, of women who participated in the Diabetes|
| |Prevention Program DPP, a landmark clinical study funded by the|
| |National Institutes of Health NIH |
| |Launched in 1995, the DPPs main results were announced in 2001 |
| |and reported in 2002 |
| |http://wwwnihgov/news/pr/feb2002/hhs-06htm: losing 5 to 7 |
| |percent of weight through diet and a consistent increase in |
| |physical activity eg, walking 5 days a week 30 minutes a day |
| |reduced the onset of type 2 diabetes by 58 percent
Treatment |
| |with metformin lowered the chances of developing diabetes by 31 |
| |percent |
| |To combat the dual epidemics of obesity and type 2 diabetes, |
| |Americans need to know about the proven benefits of losing some |
| |weight through calorie reduction and increased physical |
| |activity, said NIH Director Elias A Zerhouni, MD |
| |The DPP randomly assigned 3,234 overweight people with |
| |higher-than-normal blood glucose levels to one of three |
| |approaches to prevent type 2 diabetes: dietary changes and |
| |increased physical activity aimed at a 7-percent weight loss; |
| |treatment with the oral diabetes drug metformin; or placebo The |
| |last two groups were also given standard medical advice about |
| |diet and weight loss In the study, 660 women were randomly |
| |assigned to intensive lifestyle changes, 636 to metformin |
| |treatment, and 661 to placebo Their average age was 50 years |
| |old, with an average body mass index of 35
eg, a 5 4 woman |
| |weighing 204 pounds |
| |Women who implemented intensive lifestyle changes and lost 5 to 7|
| |percent of their weight had fewer episodes of weekly incontinence|
| |compared to those in the metformin or placebo groups 38 percent |
| |vs 48 percent vs 46 percent, respectively |
| |Our findings reinforce the DPPs good news about the benefits of|
| |modest weight loss A 200-pound woman who loses 10 to 15 pounds |
| |not only lowers the risk of developing type 2 diabetes but also |
| |improves bladder control, said lead author Jeanette S Brown, |
| |MD, of the University of California, San Francisco If youre |
| |a woman at risk for type 2 diabetes, preventing or delaying |
| |diabetes and improving bladder control are powerful reasons to |
| |make these lifestyle changes |
| |Weight loss was particularly effective in reducing episodes of |
| |stress incontinence - leakage of small amounts of urine during |
| |physical movement, such as coughing, sneezing, and
exercising |
| |Stress incontinence results, in large part, from a weakening of |
| |the pelvic floor muscles that support the bladder Though |
| |researchers do not fully understand all the factors contributing |
| |to stress incontinence, it is linked to obesity, diabetes, and |
| |other conditions, such as pregnancy, which increase pressure on |
| |the pelvic floor In the DPP participants, weight loss did not |
| |alleviate urge incontinence - leakage of urine at unexpected |
| |times Urge incontinence is more closely linked to overactive |
| |nerves that control the bladder, sometimes triggering |
| |inappropriate contractions |
| |More than 13 million people in the United States, mostly |
| |middle-aged and older women, experience loss of bladder control |
| |Overweight women and those with type 2 diabetes have a 50- to |
| |70-percent increased risk of incontinence In the National Health|
| |and Nutrition Examination Survey 2001-2002 sample, one out of |
| |three women with diabetes or prediabetic
glucose levels reported |
| |weekly or more frequent episodes of UI |
| |Some studies have reported that increased physical activity |
| |worsens incontinence, but DPP participants randomly assigned to |
| |lifestyle changes, who typically chose walking as their physical |
| |activity, did not have increased problems with incontinence |
| |Urinary incontinence is a costly, socially isolating condition |
| |that impairs quality of life and takes a psychological toll on |
| |many women For women at risk for type 2 diabetes, losing a |
| |modest amount of weight is likely to alleviate incontinence, |
| |especially stress incontinence, said Leroy Nyberg, MD, PhD, |
| |of the National Institute of Diabetes and Digestive and Kidney |
| |Diseases NIDDK, which funded the study |
| |Nearly 21 million people in the United States - 7 percent of the |
| |population - have diabetes, the most common cause of blindness, |
| |kidney failure, and amputations in adults and a major cause of |
| |heart disease and stroke Type 2
diabetes accounts for up to 95 |
| |percent of all diabetes cases The prevalence of type 2 diabetes |
| |has risen dramatically in the last 30 years, due mostly to the |
| |upsurge in obesity In addition, about 40 percent of US adults |
| |ages 40 to 74 - 41 million people - have prediabetes, which |
| |raises the risk of developing type 2 diabetes and cardiovascular |
| |disease |
| |The NIDDK funds a great deal of research to improve the treatment|
| |and prevention of diabetes and urologic disorders These efforts |
| |include the Urinary Incontinence Treatment Network |
| |http://wwwuitnnet/ and the Specialized Center of Research on |
| |Lower Urinary Tract Dysfunction in women, a multidisciplinary |
| |translational research center at the University of California, |
| |San Francisco http://wwwucsfedu/scor Recently, NIDDKs |
| |Central Repository https://wwwniddkrepositoryorg, which |
| |houses data collected in large clinical trials funded by the |
| |Institute, made data from the DPP
available to researchers free |
| |of charge |
| |The NIDDK also sponsors Lets Talk about Bladder Control for |
| |Women, a campaign to inform women about treatments for |
| |incontinence, from pelvic floor exercises to surgery For more |
| |information, call 1-800-891-5388 or see http://wwwniddknihgov|
| |The National Diabetes Education Program |
| |http://wwwndepnihgov/, jointly sponsored by the NIH, the |
| |Centers for Disease Control and Prevention, and 200 partner |
| |organizations, is disseminating the DPPs good news through its |
| |education campaign, Small Steps Big Rewards Prevent type 2 |
| |diabetes |
| |http://wwwndepnihgov/campaigns/SmallSteps/SmallSteps_indexht|
| |m |
| |The National Institutes of Health NIH - The Nations Medical |
| |Research Agency - includes 27 Institutes and Centers and is a |
| |component of the U S Department of Health and
Human Services |
| |It is the primary Federal agency for conducting and supporting |
| |basic, clinical, and translational medical research, and it |
| |investigates the causes, treatments, and cures for both common |
| |and rare diseases For more information about NIH and its |
| |programs, visit http://wwwnihgov |
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