Largest Diet and Exercise Trial in the World for Type 2 Diabetes

A massive grant of almost a million pounds has been awarded to the University of Bristol to carry out a major trial that will assess the effects of diet and exercise on people with type 2 diabetes. This trial will be the largest diet and exercise trial in the world for people with type 2 diabetes.

The recent large rise in the number of people suffering from type 2 diabetes is closely linked to the increase in obesity within the population, and this is thought to be due to a lack of exercise and an increase in food intake. Although we know a lot about how diet can control glucose levels and improve blood pressure and cholesterol, very little is known about how, or if, exercise affects these factors. This study aims to definitively answer these questions for the first time.

Dr Robert Andrews from the University of Bristol, who will lead the trial, said: “This is the largest exercise trial to be conducted in this country, and the largest exercise trial in the world for people with type 2 diabetes. We feel it will be a land mark trial from which crucial information on long-term glucose control, insulin sensitivity, insulin resistance, weight and blood pressure will emerge, allowing us to compare the effects of these conditions in each of the groups”.

The trial aims to recruit 750 people from across the Southwest who have been newly diagnosed with type 2 diabetes. Individuals will be allocated to one of three groups. Those in the first group will receive regular help and advice on improving their diet, the second group will receive the same dietary advice, but in addition they will receive help to increase their daily levels of exercise. The control group will receive the usual care.

Dr Ashley Cooper, also from the University of Bristol, said: “Participants in the exercise group will wear activity monitors all day every day. As they walk around and go about their daily business, these instruments will monitor just how many calories they are burning. Participants will be set targets to aim for so that they gradually increase the amount of exercise they do”.

Individuals will be recruited onto the trial within five months of being diagnosed and will remain in the trial for a year. The trial itself will run for three years.

Type 2 diabetes, previously known as ‘adult-onset diabetes’, commonly starts in adulthood, after the age of 30. In the last 30 years the number of people with type 2 diabetes has trebled and a further trebling in the number of patients is expected in the next ten years. This huge rise is closely linked to the recent increase in obesity within the population and threatens to be a major health problem in the future, if people cannot be persuaded to change their life styles.

Diabetes is a condition where the body can no longer control its blood sugar level. Without adequate control the level tends to rise dramatically and remains high. Over time, these high levels can result in damage to blood vessels leading to heart disease, stroke, blindness, kidney failure, impotence, circulatory problems and nerve damage.

The trial will be launched in November 2004. ‘Education days’ will be set up and doctors’ surgeries across the Southwest, from Gloucester to Taunton, will be able to refer patients newly diagnosed with type 2 diabetes to an education day. Patients attending these days will be given information about the study and be offered the opportunity to enter the trial.

The programme is a joint study between three departments at the University of Bristol. Drs Robert Andrews and Ashley Cooper in the Department of Exercise and Health Sciences, Dr Colin Dayan from Henry Wellcome Laboratories for Integrative Neuroscience and Endocrinology, and Dr Alan Montgomery and Professors Tim Peters and Debbie Sharp in Primary Health Care. The grant from Diabetes UK (£240,000) is supported by a further £680,000 from the Department of Health.