Although nearly a third of U.S. adults were at high risk for developing type 2 diabetes in 2005–2006, about 7% knew of their risk status, and only about half of those said they adopted risk reduction behaviors, data from the 2005–2006 National Health and Nutrition Examination Survey suggest.
Furthermore, of those who were aware of their risk status and who received health care in the year prior to the survey, only 35% said they were advised by their physician to try to control or lose weight, 37% said they were advised to reduce fat or calorie intake, and 39% said they were advised to increase physical activity, Linda S. Geiss of the Centers for Disease Control and Prevention, Atlanta, and her colleagues reported.
The data—from 1,391 adults aged 20 years and older without diabetes who participated in the survey—showed that reports of physician advice was strongly associated with reports of engaging in risk-reduction behaviors during the past year. Of those who received physician advice about weight loss or control, diet, and physical activity, 75%, 82%, and 71%, respectively, reported following the advice, the investigators said (Am. J. Prev. Med. 2010 April [doi:10.1016/j.amepre.2009.12.029]).
The multivariate adjusted prevalence of trying to control or lose weight, reduce fat or calorie intake, and increase physical activity for those who received advice vs. those who did not was 71.0 vs. 44.2, 81.2 vs. 42.3, and 67.9 vs. 38.4 for each behavior, respectively, the researchers found.
The findings are important because prevention trials consistently show that diabetes risk can be reduced substantially through modest weight loss and increased physical activity. However, improved efforts on the part of physicians to advise patients about lifestyle modifications are likely to be insufficient, as it has not been shown to be associated with maintaining the changes, they explained.
“Prevention promotion by physicians and other health professionals may be more effective if part of a larger process within healthcare systems and communities to promote behavior change,” they wrote. They went on to say that prospective studies of interventions and policies to promote and maintain healthy lifestyles with more objective measures of behaviors and outcomes are needed, as are studies on why and when people are screened for diabetes and counseled about behavior modification, and studies on what types of counseling are effective.
“Reversing the national trends in diabetes incidence is likely to require multiple tiers of interventions,” they wrote, noting a need for increased promotion of risk reduction behaviors, increased availability of evidence-based programs for those at risk, and more efficient identification and awareness of risk on the part of patients, providers, health care systems, and health payers.
Disclosures: The authors reported no financial disclosures.