Weight loss and exercise will affect the numbers, the surrogate measures of the disease, and so will the pills. However, no one has yet proved that making the numbers go in the right direction will alter the course of the disease in terms of morbidity and mortality. That would take decades, and no pharmaceutical company wants to run a study that long, so they go for results just in terms of the A1c or lower cholesterol.
The one large study done in the UK many years ago supposedly demonstrates a benefit, but it is measured in terms of reduction in relative risk which can be very deceiving. Also, they did a lot of massaging of the data to even show that small benefit.
There has not been one good study that has proved that weight loss will lengthen one’s life. People may want to lose weight (and most will not be successful in the long run) because it makes them feel better, etc. but there is no guarantee that it will make one live longer.
There is much more we don’t know about obesity and diabetes than we do know, but this deviates from Holy Writ concerning these conditions. People need to keep an open mind and see some real proof, not just in adjusting various numbers in tests, but actual benefit to the patient, before they swallow the accepted wisdom.
Recommend The Obesity Myth by Paul Campos (he is a bit of a lib and goes off on tangents at times, though) and any book by Dr. Nortin Hadler, MD. His latest on aging is excellent.
One more... Overdiagnosed by H. Gilbert Welch.
“However, no one has yet proved that making the numbers go in the right direction will alter the course of the disease in terms of morbidity and mortality. “
Exactly. See below:
Another interesting study:
Heart failure patients with diabetes may benefit from higher glucose levels
http://www.uclahealth.org/body.cfmid=561&action=detail&ref=1880
The researchers found that for the diabetic heart failure patients, two-year event-free survival was highest among patients with the highest elevated glycosylated hemoglobin levels: a 65 percent survival rate for patients with Level 4 (greater than 8.6 percent of the marker) and a 61 percent survival rate for those with Level 3 (7.3 - 8.5 percent of the marker).