Effects Comparison Between Pre-diabetes Lifestyle Intervention And Drug Intervention

Objectives Lifestyle Modification and Metformin Intervention are two common approaches to prevent or delay diabetes. This study aims to get more effective and safe approach by comparing and contrasting the the two approaches. These indicators such as the changes of blood sugar and weight, the compliance of two interventions, and the incidence of adverse events are used in the study.Methods The study is a pragmatic, randomized, experimental prospective cohort study. Test on September 12,2007 in Henan Polytechnic School Hospital, University Hospital of organizational unit, follow-up time was 2 years.234 cases selected for testing in patients with diabetes, both workers and their families in Henan University of Technology. Age 25-80 years old. Subjects were randomly assigned into two groups,One is to receive lifestyle interventions (low-calorie diet 30Kal/Kg.day.30 minutes of exercise a day, at least 5 days per week; n=117) Another is metformin (0.25-0.5, three times a day, according to blood glucose levels adjustment; n=117). Application of SPSS 11.5 software for statistical analysis. Whichever is non-normal data were converted to normal distribution of natural logarithm of information into the statistical analysis. Between the two groups using u test before and after the index intervention was used to compare the difference between the changes in baseline indicators for the covariate analysis of covariance. U test was used to compare rates. Logistic regression analysis is used Multivariate analysis.Results During the intervention, lifestyle group,15 patients (13.51%) progressed to diabetes, metformin,6 cases (5.22%) progressed to diabetes. (hazard ratio,HR,2.59; P<0.05). Metformin group was 75.7% compliance and no serious adverse events. Only 5 out because of gastrointestinal symptoms. Lifestyle intervention group was 54.5% compliance, the other two fasting blood glucose level of the end of life the average 6.11±0.32mmol/L, the average fasting blood glucose level metformin 5.61±0.26mmol/L. (P< 0.05) two-hour postprandial blood glucose an average of the two groups were (8.15±1.31mmol/L,7.19±1.15mmol/L, P<0.05),mean glycated hemoglobin level of 6.1%,5.7%(P<0.05). Intervention in the first half of both groups body weight, IBM has declined; Since then, the metformin group remained stable over the baseline while the lifestyle group. End of the study, the average weight loss metformin group reduced 2.2kg, lifestyle group but increased by 0.5kg (P<0.01) metformin group had mild to moderate gastrointestinal tract adverse events was 6%～14%.3～14% of the lifestyle group. No serious adverse reactions.Conclusion The real-life environment, lifestyle interventions, although effective, but compliance is poor, if not to maintain strict clinical follow-up can not produce the desired results, metformin good compliance, security and the effect is obvious, especially for middle-aged, overweight persons to benefit the most.