Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study
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Aims/hypothesis We determined the effects of 6 years of lifestyle intervention in persons with impaired glucose tolerance (IGT) on the development of retinopathy, nephropathy and neuropathy over a 20 year period.Methods In 1986, 577 adults with IGT from 33 clinics in Da Qing, China were randomly assigned by clinic to a control group or one of three lifestyle intervention groups (diet, exercise, and diet plus exercise). Active intervention was carried out from 1986 to 1992. In 2006 we conducted a 20 year follow-up study of the original participants to compare the incidence of microvascular complications in the combined intervention group vs the control group.Results Follow-up information was obtained on 542 (94%) of the 577 original participants. The cumulative incidence of severe retinopathy was 9.2% in the combined intervention group and 16.2% in the control group (p = 0.03, log-rank test). After adjusting for clinic and age, the incidence of severe retinopathy was 47% lower in the intervention group than the control group (hazard rate ratio 0.53, 95% CI 0.29-0.99, p = 0.048). No significant differences were found in the incidence of severe nephropathy (hazard rate ratio 1.05, 95% CI 0.16-7.05, intervention vs control, p = 0.96) or in the prevalence of neuropathy (8.6% vs 9.1%, p = 0.89) among the 20 year survivors.Conclusions/interpretation Lifestyle intervention for 6 years in IGT was associated with a 47% reduction in the incidence of severe, vision-threatening retinopathy over a 20 year interval, primarily due to the reduced incidence of diabetes in the intervention group. However, similar benefits were not seen for nephropathy or neuropathy.
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At 20 years in the DaQing Study, other microvascular complications like nephropathy and neuropathy occurred at rates similar to controls.
“while the rates of other microvascular complications, such as nephropathy and neuropathy, were similar as in controls.119”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [119]
At 20 years in the DaQing Diabetes Prevention Study, lifestyle intervention cut diabetes risk by 43% and postponed onset by an average of 3.6 years.
“In the 20-year follow-up of the DaQing Diabetes Prevention Study, for example, those receiving a lifestyle intervention had a 43% reduced risk of diabetes, translating to a mean 3.6 year delay in the development of diabetes.119”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [119]
At 20 years in the DaQing Study, lifestyle intervention was tied to a nearly 50% lower relative risk of new severe retinopathy.
“In the 20-year follow-up of the DaQing Study, the lifestyle intervention was also associated with an almost 50% reduction in the relative risk of incident severe retinopathy”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [119]
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Self-citation
- Authors
- Gong, Q., Gregg, E. W., Wang, J., An, Y., Zhang, P., Yang, W., Li, H., Li, H., Jiang, Y., Shuai, Y., Zhang, B., Zhang, J., Gerzoff, R. B., Roglic, G., Hu, Y., Li, G., & Bennett, P. H.
- Affiliations
- China-Japan Friendship Hospital (CN)
- Centers for Disease Control and Prevention (US)
- Daqing Oilfield General Hospital (CN)
- National Institutes of Health (US)
- Corresponding author
- Li, G.
- Venue
- Diabetologia
- Published
- 2010-11-03
- Volume
- 54
- Issue
- 2
- Pages
- 300-307
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2067941747
- Cited by
- 251
- References
- 32
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 14 · 2023: 12 · 2022: 15 · 2021: 11 · 2020: 12 · 2019: 16 · 2018: 20 · 2017: 17 · 2016: 18 · 2015: 29 · 2014: 25 · 2013: 22 · 2012: 14
- FWCI
- 10.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Funders
- American Diabetes Association
- Centers for Disease Control and Prevention (U58/CCU424123‐01‐02)
- U.S. Public Health Service (U58/CCU424123-01-02)
- China-Japan Friendship Hospital
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- impaired glucose tolerance, lifestyle intervention, diabetes prevention, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, microvascular complications, diet and exercise, long-term follow-up
- MeSH terms
- Adult, Diabetes Mellitus, Diabetic Nephropathies, Diabetic Neuropathies, Female, Humans, Life Style, Male, Middle Aged, Glucose Intolerance, Diabetes Complications
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