Diabetes (especially type II diabetes) was not a very common disease in the developing countries, but it has become more common these days. Over the years the incidence of diabetes, especially type II diabetes is becoming equally common in developing and developed countries.

In United States 1 in every 9 are reported to be diabetic and most of them are having type II diabetes, which has a genetic predisposition and develops during adulthood. There are also an additional 57 million (approximately 20% of Americans) individuals in United States who have Pre-Diabetes (blood glucose higher than normal, but not yet diabetic). This is the group which will benefit most from intervention strategies like lifestyle modification. Lifestyle modification can delay to a great extent the development of diabetes in Pre-Diabetes individual.

In a Diabetes Prevention Program which involved 3234 obese and overweight individuals (both men and women) with more than average risk of developing diabetes were divided into three groups for study. The first group was trained intensively about lifestyle modification, the second group received anti-diabetic (oral hypoglycemic) medicine metformin, and the third group was given placebo.

The first group was given low fat diet and regular moderate exercise to reduce body weight by 5-7%. This group on an average exercised 30 minutes a day. As a result they managed to lost 15 pounds. The second group with metformin lost average 5 pounds and the third group of placebo lost less than 2 pounds.
After the study was halted (when it became crystal clear that lifestyle modification is the most effective to delay diabetes) it was seen that those who modified their lifestyle reduced the risk of diabetes by 58% in compare to the placebo group. The group which received metformin reduced the risk of diabetes by 31% in compare to placebo.

Approximately half (total of 1766 and approximately half of every group) of the original study group (3234) was followed up for 10 years and all of them were given lifestyle modification training. After 10 years follow up it was observed that in the original lifestyle modification group, there was a delay of average four years for onset of diabetes in compare to original placebo group and average two years delay in onset of diabetes in the metformin group. Approximately 5% participants in the lifestyle modification group, 8% in the metformin group and 11% in the placebo group developed diabetes every year during the follow up study.

Lifestyle change has become more important because of the spread of diabetes in epidemic throughout the world. The above study clearly indicates it is the most effective way to delay onset of diabetes.