Type 2 diabetes is a metabolic disorder which mainly caused by the deficiency of insulin or insulin resistance (Oggioni, 2014, pp.1105-1111). According to Chatterjee, Khunti and Davies (2017, pp.2239-2251), It could result in macrovascular and microvascular complications that increase the distress of patients both mentally and physically. Moreover, a recent investigation indicated the worldwide amount of diabetics is 415 million and more than 90% of patients have type 2 diabetes (Chatterjee, Khunti and Davies, 2017, pp.2239-2251). In the prediction of Esparza-Romero, J. et al. (2015) in 2014, the number of diabetics will increase to 592 million in 2035, which raising the global burden of diabetes. Based on the study of Chatterjee, Khunti and Davies (2017, pp.2239-2251), more than three-fifths of people with type 2 diabetes are obese, which obesity could be the principal cause of the global increment. In order to reduce the incidence of this illness, lifestyle modification program (Bray, 2002, pp.393-403) in both physical activities and dietary patterns is an effective method. This essay will discuss both advantages from an experimental perspective and withdraws to its accuracy and feasibility, before summarizing that through continuous improvement the positive effect of this project will be greater.
Obesity remains the most significantly risk factor in the numerous causes of type 2 diabetes. Golay and Ybarra (2005, pp.649-663) claimed that because the relationship between type 2 diabetes and obesity is so close, a term called ‘diabesity’ has been coined to refer to both of them, which over approximately 60 percent of diabetics have obesity (Chatterjee, Khunti and Davies, 2017, pp.2239-2251). A certain amount of obese patients have similar symptoms with diabetics such as a progressive defect in insulin secretion and increasing resistance of insulin, which their obesity is more possible to convert into diabetes (Golay and Ybarra, 2005, pp.649-663).
To solve this issue, a lifestyle intervention project was implemented by an American diabetes prevention program research group from 1996 to 1999 (Bray, 2002, pp.393-403), which indicated the treatment of lifestyle modification was more effective than drug therapy. According to Bray (2002, pp.393-403), this intensive modification project has two main elements: physical activities and dietary patterns which the former requires participants to engage in medium intensity activity such as jogging over two and a half hours per week while the latter needs people to attend lessons including low-fat and low-calorie diet, behavior modification in order to treat diabetes. In this controlled trials, more than 3200 participants were randomly assigned into 3 groups about placebo, metformin (850mg twice daily) and a lifestyle intervention program (Bray, 2002, pp.393-403). Through approximately 3-year follow-up, the incidence of type 2 diabetes was 4.8 per 100 person-years in the lifestyle group compared with 7.8 in the metformin group and the reduction of incidence in the former was nearly 60 percent versus 31 percent in the latter Bray (2002, pp.393-403). Therefore, according to the experimental comparison above, the lifestyle modification program is a more effective measure to treat diabetes.
The key benefit of the lifestyle intervention project based on the experiment from 1996-1999 is typical. It proved the finding’s applicability to America’s ethnically and culturally diverse population (Bray, 2002, pp.393-403). Turner et al. (1998, pp.837-853) pointed out that the relatively previous studies were affected by the restriction of the types of regions and people that merely focused on a single category instead of a variety of variables in a worldwide range which could have the impact on the result of this experiment. However, this study especially concentrated on the United States where it has a great diversity of the region and ethnic groups, containing Asians, Africans, Hispanics, American Indians and Pacific Islanders (Harris et al., 1998, pp.518-524). Therefore, because of considering most external factors which could affect the process of experiment, the consequence of this study is more rigorous and scientific.
Secondly, the application of lifestyle intervention was also available and effective in other countries which display its universality. An experiment in Finland from Tuomilehto (2001, pp.1343-1350) received a similar risk reduction about diabetes’ incidence. In addition, the result of Pan (1997, pp.537-544) in China had a higher reduction in incidence which was almost 45 percent of lifestyle modification in both diet and exercise. These phenomena indicate that the measure of lifestyle intervention had positive outcomes in a worldwide range.
Nevertheless, there are also drawbacks associated with this measure. A Key problem is the feasibility of this program (Dunkley, 2014, pp.922-933) of this measure. According to Dunkley (2014, pp.922-933), it is a long term for lifestyle intervention program to play its role which also highly requires the adherence and body conditions of participants to strictly follow instructions about changing their bad habits of diet and keeping exercises. Besides, all the experiments mentioned in the essay have not only a strict procedure to select participants but also a professional management team with all kinds of precise instruments to supervise the whole process in order to achieve the experimental goal. It means that the experimental results are almost idealized and still in the trial stage while all these trials need a huge amount of money to provide support. Therefore, it still has a long way to convert the lifestyle intervention experiment into a pragmatic treatment plan that allows universal participation.
Furthermore, the definition of ‘lifestyle intervention’ is too general that there is no clear identification of different kinds of dietary changes and physical exercise (Yates, 2007, pp.1116-1126). From Bray (2002, pp.393-403), part of relative experiments merely focuses on exploring the effectiveness of using lifestyle modification to decrease the incidence of type 2 diabetes instead of further researches about which elements or combinations in lifestyle changes have more significant roles in reducing the incidence. It is necessary to explore the relationship between age, gender, body condition and lifestyle modification through more detailed experiments in order to figure out the optimum treatment for patients to follow in both physical activities and dietary patterns.
To summarize, this essay has mentioned obesity as the main cause of the higher incidence of type 2 diabetes and evaluated the lifestyle intervention as a possible solution to the worldwide increment in this illness. Although the identifications of physical activity and dietary in lifestyle intervention program are not clear enough and time-effectiveness as well as cost-effectiveness still need to be adjusted, through more relative experiments in different regions and races, the feasibility of this measure applies to the universal population will be higher and higher. Overall, it is possible to achieve a longer term maintenance of lifestyle modification by optimal strategies through more researches and finally decrease the incidence of type 2 diabetes.