The value of diet and lifestyle change including the incidence of type-2 diabetes mellitus has been clearly demonstrated in three recent studies with
Table 2. Coronary heart disease risk factors associated in type-2 diabetes mellitus
1 Low high-density lipoproteins (high triglycerides)
2 Modified low-density lipoproteins (glycosylated, oxidized, acetylated)
3 Raised blood pressure
4 Raised uric acid levels (a primary factor or simply an indicator of other abnormalities?)
5 Raised serum free fatty acid levels
7 Raised factors VII and VIII, fibrinogen, and plasminogen activator inhibitor, and low tissue plasminogen activator levels reductions of 30-50% in diabetes incidence in high-risk groups [24-26]. The Diabetes Prevention Program trial found that diet and lifestyle reduced the diabetes incidence by 58% and was more effective than metformin at 31% risk reduction . Epidemiological studies, notably the Nurses Health Study, attributed 91% of the risk of type-2 diabetes to five major diet and lifestyle factors which included regular exercise, a body mass index of <25kg/m2, cereal fiber and consumption of low glycemic index diets .
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