For people predisposed to developing type 2 diabetes, a new study in The Lancet suggests that the disease may be delayed or even prevented by making some healthy lifestyle changes. What’s more, engaging in the healthy duo – diet and moderate exercise – decreased diabetes risk even more effectively than taking the widely prescribed anti−diabetes drug metformin.

Approximately 57 million people have elevated blood sugar levels, putting them at risk for developing heart disease and type 2 diabetes. Prevention is considered the best “weapon” in fighting the growing diabetes epidemic. Lead author William C. Knowler says that weight loss is “clearly to be recommended” for those who are predisposed because of high blood sugar or other factors.

Approximately 57 million people have elevated blood sugar levels, putting them at risk for developing heart disease and type 2 diabetes. Prevention is considered the best “weapon” in fighting the growing diabetes epidemic.

In the current study, over 3,000 at−risk individuals were divided into three groups at random. The first group was asked to make lifestyle changes – reducing fat and total calorie intake, and exercising for at least 150 minutes per week. The second group was prescribed the drug metformin, which stabilizes blood sugar and reduces cholesterol and triglyceride levels. The third group was given placebo, and served as a control.

Three years into the study, those in the diet and exercise group were 58% less likely to develop diabetes than those in the placebo group. Those taking metformin were at 31% reduced risk.

These noteworthy results prompted the researchers to change things up a bit: they now offered all three groups access to counseling and support for the remainder of the study. At the end of ten years, those in the original diet and exercise group had a 34% reduced risk of developing diabetes compared to the placebo group. And of the dieters and exercisers who did develop the disease , its onset was four years later than that of the placebo group. Participants who took metformin were 18% less likely to develop diabetes, and of those who did develop it, its onset was delayed by two years.

The results were even more pronounced for seniors: those who dieted and exercised cut their risk in half over the ten year period.

Knowler says that the findings underline “the fact that the lifestyle intervention, whether it was given immediately, or later on, was beneficial.” He and his team hope to continue tracking the participants for another five years, paying particular attention to how the development of diabetes−related health concerns (like neuropathy and blindness) are affected by diet and exercise and metformin.

The study was carried out by researchers at U.S. National Institute of Diabetes and Digestive and Kidney Diseases.