Lifestyle changes like diet and exercise may not only prevent type 2 diabetes but may reverse it, according to a Brigham Young University study published today in the Journal of the American Association of Occupational Health Nurses.
The vast majority of diabetes cases — 94 percent — are type 2, which typically develops later in life and can lead to many complications, including blindness, limb amputation and kidney disease. It sometimes kills.
Estimates say as many as 9 percent of Americans have type 2 diabetes, some of them without knowing it.
"There have been great randomized clinical trials that looked at this very issue and which have proven with little doubt that (type 2 diabetes) is a lifestyle issue," said Steve Aldana, BYU professor of health and human performance and author of "The Culprit and the Cure." "What we don't have is anybody doing anything about it."
What to do was the focus of the BYU research. For the study, Aldana's team designed a wellness program for B.D. Medical, a medical device company, then followed participant results. The program was based on what Aldana calls the "common denominator of care" in the United States for any health issue, whether diabetes or heart disease, high blood pressure or cancer. "It's the same solution: controlling food quantity, improving food quality and getting regular activity," he said.
The BYU researchers screened employees to see who had or was at risk of developing diabetes. Those workers were invited into the yearlong health program. Participation was voluntary and employees at B.D. gained access to educational material and 16 weeks of short classes on healthy living, including food and nutrition, exercise and more. For motivation, people who had been there, done that came in to share their successes.
They were given tools, like instructions for how to make tasty meals at home that everyone would eat or how to make wise choices when eating out. They talked about what to do on a day when there's no chance to go exercise. Each participant was expected to exercise 30 minutes a day, the choice of activity their own.
Finally, the work environment was physically changed to facilitate wellness. B.D. Medical installed a small fitness center that employees were encouraged to use. Healthier food choices were added to the menu in the cafeteria.
"You want to make it so people can adhere" to healthy lifestyles, Aldana said.
Participants were screened for blood insulin levels and glucose intolerance at the beginning, at six months and a year after the program started.
The study's two-year data shows that the majority of participants who were diabetic no longer are and cardiovascular risk factors declined as well. Now they're doing follow-up to see how long the changes last, he said. "So far, it looks really good." And the company plans to keep the program growing.
Participation rates were high in part because the company was committed to the wellness program. Corporate commitment makes sense, Aldana said, because an employee with diabetes can cost $300,000 in health care expenses. Nationally, $132 billion is spent a year treating diabetes.
"This is a company that's been aggressive about it, and it will reap financial rewards and have higher employee morale," Aldana said. "This has changed employees' lives for better."