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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ETwenty-three years of follow-up data from the China Da Qing Diabetes Prevention Study (CDQPDS) show that lifestyle intervention to prevent diabetes can reduce all-cause and cardiovascular mortality among women with impaired glucose tolerance but not among men.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ETwenty-three years of follow-up data from the China Da Qing Diabetes Prevention Study (CDQPDS) show that lifestyle intervention to prevent diabetes can reduce all-cause and cardiovascular (CV) mortality among women with impaired glucose tolerance (IGT) but not among men. Findings from the study were reported by Guangwei Li, MD, Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EIn 1986, 577 adults with IGT from 33 clinics in Da Qing, China, were randomly assigned to a control group or 1 of 3 lifestyle intervention groups (diet, exercise, or diet plus exercise). Active intervention was carried out from 1986 to 1992. Participants who were assigned to the exercise group or diet-plus-exercise group were encouraged to increase the amount of their physical activity by at least 1 unit per day (as defined in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E) and by 2 units per day, if possible, for participants aged \u0026lt;50 years with no evidence of CV disease (\u003Ca id=\u0022xref-table-wrap-1-2\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E) [Pan XR et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 1997].\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12750\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12750\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12750\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-4\u0022 class=\u0022first-child\u0022\u003EActivities Required for Increasing Activity by One Unit of Exercise.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-5\u0022\u003EA 20-year follow-up study showed that group-based combined lifestyle interventions over 6 years in people with IGT can prevent or delay diabetes for up to 14 years after the active intervention [Li G et al. \u003Cem\u003ELancet\u003C\/em\u003E 2008]. Lifestyle intervention for 6 years in IGT was also associated with a 47% decline in the incidence of severe, vision-threatening retinopathy over 20 years [Gong Q et al. \u003Cem\u003EDiabetologia\u003C\/em\u003E 2011].\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe aim of the current trial was to examine all-cause and CV mortality among those who participated in the 6-year lifestyle intervention that was implemented in the Da Qing Diabetes Prevention Study. In 2009, 23 years after randomization, participants were traced to determine the long-term impact of the interventions on mortality; 47 women and 127 men had died.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EMortality rates were compared between the control groups and the combined intervention groups (diet, exercise, and diet plus exercise). All-cause mortality was defined as death from any cause. CV mortality was defined as death from coronary heart disease, stroke, and sudden death.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EIn women, combined lifestyle intervention (diet, exercise, and diet plus exercise) reduced all-cause mortality by 53% (hazard rate ratio [HRR], 0.47; 95% CI, 0.25 to 0.86), with cumulative all-cause mortality of 16.2% (95% CI, 11.2 to 21.2) in the intervention group versus 29.3% (95% CI, 17.5 to 48.0) in the control group (p=0.02). Among men, there was no significant difference in cumulative all-cause mortality (p=0.41) between the combined intervention and control groups (41.1% versus 46.7%).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe reduction in all-cause mortality in women was mainly because of differences in CV mortality (heart disease and stroke; HRR, 0.30; 95% CI, 0.12 to 0.68), with 23-year cumulative mortality of 6.8% in the intervention group (95% CI, 3.4 to 10.2) versus 18.8% (95% CI, 8.8 to 28.8) in the control group (p=0.006). In men, there was also no significant difference in cumulative CV mortality (p=0.47) in the combined intervention and control groups (26.4%; 95% CI, 21.1 to 31.6 versus 27.4; 95% CI, 18.6 to 32.2).\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EData from the intervention groups (diet, exercise, and diet plus exercise) suggest that combined lifestyle intervention significantly lowers all-cause and CV mortality among women with IGT but not among men. Reasons may include a large difference in baseline smoking rates between men and women.\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EApart from diabetes, measures of risk factors for death (and CV disease) at baseline and during the trial were limited. In turn, the investigators were unable to identify or exclude possible confounding factors for the differences in outcomes between women and men. The reasons remain unclear.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EParticipants in the intervention group were, on average, 2 years younger than those in the control group, but there were no differences in baseline body mass index (BMI) in controls, 26.2\u00b10.2 kg\/m\u003Csup\u003E2\u003C\/sup\u003E versus BMI in the combined intervention group, 25.7\u00b10.2 kg\/m\u003Csup\u003E2\u003C\/sup\u003E. The changes in body weight during the active-intervention period (1986 to 1992) and the entire follow-up period (1986 to 2006) did not differ significantly by group [Guangwei L et al. \u003Cem\u003ELancet\u003C\/em\u003E 2008].\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/10\/31.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznffp\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nznffp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}