Mark DeBoer, MD (photo courtesy of UVA Connect)
November 8, 2018
A simple scoring system can track the reduction in diabetes risk produced by lifestyle changes and medication in people with pre-diabetes, a new study has found. The findings suggest the potential that the tool could be a good way to motivate patients to stick with the diet and exercise changes that could save them from developing full-blown diabetes.
The scoring system also may be useful for comparing the effectiveness of different diabetes interventions, the researchers report.
“We knew that a person’s MetS severity score helped predict their future chances of developing diabetes and heart disease; this was the first time we have been able to show that a decrease in score during treatment reflected a decrease in risk of future disease,” said researcher Mark DeBoer, MD, a University of Virginia Children’s Hospital pediatrician who developed the scoring system with his colleague Matthew J. Gurka, PhD, at the University of Florida. “This means that following the score over time gives a patient an indication if their recent changes in exercise and diet are helping to decrease their chances of developing diabetes.”
Type 2 Diabetes: Many at Risk
More than a quarter of Americans have pre-diabetes, meaning they are at elevated risk of developing type 2 diabetes. Eating healthier, losing weight and exercising more can reduce that risk, but those changes are hard, and many people struggle to stick with their doctor’s recommendations.
The new study suggests that the scoring system, known as the MetS Severity Score, could help them appreciate the benefits of their hard work. The system previously has been shown effective at predicting patients’ risk of diabetes, but the researchers wanted to determine if it could track changes in risk over time. The answer was yes.
“Unlike many other risk scores that can assess risk at baseline but can’t be used to follow risk over time, this score changes in a meaningful way to help both doctors and patients know if their current treatment is helping to reduce their risk,” DeBoer said.
Tracking Diabetes Risk Over Time
To determine the tool’s usefulness for predicting evolving risk, DeBoer, Gurka and researcher Stephanie L. Filipp analyzed data from 2,476 people with prediabetes who received treatment with lifestyle changes, the drug metformin or placebo. Those patients were all part of the Diabetes Prevention Program and were enrolled between 1996 and 1999. They were then followed through 2014 to determine whether they would develop diabetes.
The researchers determined that the MetS scoring system was effective at calculating the participants’ evolving risk of both diabetes and cardiovascular disease. (MetS evaluates the severity of a patient’s “metabolic syndrome,” a conglomeration of conditions that includes high blood sugar, excessive body fat around the abdomen and waist and increased blood pressure. Those are major factors in both diabetes and cardiovascular disease.)
DeBoer said that doctors may want to incorporate the MetS scoring tool, or one like it, into their practice to help patients better understand the factors that contribute to their risk for diabetes and help them appreciate the cumulative benefits of their lifestyle changes.
“We are hoping to make this score available to clinicians and patients to track their progress,” DeBoer said.
MetS Findings Published
The researchers have published their findings in the scientific journal Diabetes Care. The work was supported by National Institutes of Health’s National Heart, Lung and Blood Institute, grant 1R01-HL-120960. The Diabetes Prevention Program was conducted by the Diabetes Prevention Program Research Group, sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases.
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