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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
Open accessAbstract
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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“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]
In the citing paper
“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]
In the citing paper
“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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Metadata
- 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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