Weight management program substantially reduces risk factors for those with pre-diabetes. 

Objective: Compelling scientific data indicates lifestyle change can prevent or delay the onset of type 2 diabetes. The Diabetes Prevention Program (DPP) and other randomized controlled trials demonstrated that modest reductions in weight and increases in physical activity delay the onset of diabetes in high-risk individuals.

Method: The Health Management Resources™ (HMR^®) Program for Weight Management enables obese individuals to lose and maintain significant amounts of weight and maintain beneficial lifestyle changes. We documented the lifestyle changes and medical outcomes of 175 patients with pre-diabetes (impaired fasting plasma glucose) who participated in an ongoing weight-management treatment program that is structured and research-based, similar to the DPP. Patients lost weight using a very low, low-calorie, or moderately restricted diet. Weight loss and maintenance both emphasize the same lifestyle behaviors: record-keeping, weekly attendance, meal replacements, physical activity (> 2,000 kcals/wk), and vegetables/fruits (> 35 cup servings/wk). The sample consisted of all maintenance patients who had completed a follow-up health risk appraisal (HRA) between January 2004 and April 2005 and had a pre-treatment fasting plasma glucose 100–125 mg/dl but no diagnosis of diabetes.

Results: Initial BMI averaged 41.3 kg/m² and average maintenance of weight loss was 47 lbs. after an average of 2.6 years. There was a 217% increase in physical activity (average 863 to 2735 kcals/wk), 37% decrease in % dietary fat, and substantial increase in vegetable/fruit intake. These lifestyle changes were associated with highly significant reductions (p<.001) in all measured medical outcomes: fasting blood glucose -10.3%, total cholesterol/HDL ratio -19.2%, triglycerides -32.1%, and systolic -11 mm/Hg and diastolic blood pressure -7 mm/Hg. At follow-up, only 2% of patients were on oral diabetes medications and none were on insulin. Additionally, 38% had discontinued hypertensive or cholesterol medications.

Conclusion: An intensive weight management program similar to the DPP is effective in the clinical, non-academic setting in delaying the progression from pre-diabetes to type 2 diabetes.