Public health strategies that aim to prevent adult weight gain in the whole population have the potential to prevent twice as many cases of type 2 diabetes as strategies that target individuals.
That’s according to the authors of a study of over 33,000 people, published in the journal BMC Public Health and including a team from Cambridge.
“It would be advisable to consider both high-risk and population-based strategies for diabetes prevention”
They noted that current clinical practice and public health programmes generally targeted those at high risk of type 2 diabetes, such as people who are obese or with higher than normal blood glucose.
While there is evidence to show such programmes are effective for those targeted, their potential to affect the prevalence of diabetes in the whole population is limited, said the researchers from the UK and Sweden.
They highlighted that there was less evidence concerning the impact of moderate weight loss or weight maintenance in adults across the whole population on the occurrence of type 2 diabetes.
As a result, they sought to determine the potential to reduce the occurrence of diabetes of strategies that aim to shift the distribution of body weight in the whole population.
The researchers, from Cambridge University and Umeå University, analysed data from 33,184 people aged 30-60 years who attended two health examinations 10 years apart between 1990 and 2013.
They determined the association between change in body weight between baseline and 10-year follow-up and occurrence of newly diagnosed diabetes at follow-up, and assessed the impact of population-level shifts in body weight on the occurrence of diabetes.
In addition, they controlled for potential confounding factors, including sex, age, calendar year, family history of diabetes, tobacco use, education and marital status.
During the decade of follow-up, 3.3% of study participants developed diabetes, 53.9% gained more than 1kg/m2 relative to their starting weight and 36.2% maintained their weight.
Prevent population weight gain to reduce type 2 diabetes
Source: Ian Farrell
Compared to those who maintained their weight, people who gained more than 1kg/m2 had a 52% higher risk of diabetes.
The researchers estimated that if everyone who gained weight had maintained their weight, regardless of their starting weight, one in five of all type 2 diabetes cases in the population could have been prevented – equivalent to 21.9%.
By contrast the researchers estimated, based on previous research, that if everyone in the population at high risk of diabetes due to having a BMI over 30kg/m2 was referred to a commercial weight management programme, only 8.2% type 2 diabetes cases could be prevented.
Lead study author Dr Adina Feldman, from the Medical Research Council’s epidemiology unit in Cambridge, said: “We have shown that a population-based strategy that promotes prevention of weight gain in adulthood has the potential to prevent more than twice as many diabetes cases as a strategy that only promotes weight loss in obese individuals at high risk of diabetes.
“Thus, when it comes to body weight and diabetes, from a public health perspective it would be advisable to consider both high-risk and population-based strategies for diabetes prevention,” she said.