What is the evidence that weight control, diet, and/or exercise can prevent non-insulin-dependent diabetes mellitus?
There is strong evidence that NIDDM is genetically determined. Based on considerable epidemiologic data, it is apparent that obesity and aging promote the development of the disease in susceptible individuals. The prevalence of the disease increases steadily from the fourth decade. Individuals who are 20 to 30 percent overweight are clearly at an increased risk for NIDDM, and the risk accelerates with increased body weight. Data suggest that in addition to the degree of obesity, an increasing duration of obesity and the specific distribution of excess body fat are associated with the development of NIDDM. With regard to fat distribution, upper body or android obesity appears to be more strongly associated with diabetes than lower body or gynoid obesity. Individuals with a family history of NIDDM may develop the disease when they have only modest excess of body fat. These people should be assessed routinely for the presence of carbohydrate intolerance and encouraged to maintain desirabl
