Breakthrough in diabetes and cardiovascular disease prevention: a 30-year study of diabetes prevention in Daqing

Abstract

Type 2 diabetes represents an immense and growing public health challenge worldwide for its extremely high risk of blindness, renal failure, myocardial infarction and stroke. In the 1980s, it was unclear whether diabetes is preventable. Up to 2000, it remained unclear whether diabetes can be delayed over a long period by active lifestyle intervention and whether the benefits of diabetes prevention can extend to the prevention of diabetic vascular complications and the reduction of mortality. The Diabetes Prevention Study in Daqing is one of the first studies to answer these questions. The major lessons we learnt from this study are as follows. Over 23 years, 56% people with newly diagnosed diabetes died, of whom 50% died of cardiovascular disease (CVD) with a 10-year less life expectancy. More than 90% people with impaired glucose tolerance (IGT) experienced diabetes, 33% of whom died and 44% had at least one CVD event in the subsequent 20 years. The all-cause death and CVD events over 20 years’ follow-up period in this IGT population mainly occurred after the progression to diabetes. A group-based lifestyle interventions over 6-year period had long-term effects on prevention of diabetes beyond the period of 6-year active intervention. Benefits of the intervention significantly reduced severe diabetes retinopathy and extended to a favorable reduction of CVD and all-cause mortality. This study has an important impact on the worldwide prevention of diabetes and its vascular complications.