Healthy lifestyle is better than drugs for reversing metabolic syndrome

This systematic review addressed methods of preventing progression from metabolic syndrome or pre-diabetes to full type 2 diabetes or cardiovascular disease.

Clinical question

In people with metabolic syndrome, what interventions exist that can prevent progression to type 2 diabetes?

The evidence

The reviewers only included randomised trials in their review.  The trials did not provide enough data to perform meta-analysis for the outcomes of mortality, incidence of type 2 diabetes or cardiovascular disease.

However, the reviewers were able to perform a meta-analysis for reversal of metabolic syndrome, using data from 13 studies  involving 3907 participants.

They concluded that both lifestyle and drug treatments are effective at reversing, and that lifestyle interventions are more effective than drugs.

Appraisal hints:

Users of this research should consider:

  • The comprehensiveness of the literature search.
  • Whether the specific interventions described in each study are similar enough to warrant being combined in a meta-analysis.
  • How feasible it is to deliver the interventions in practice, away from the research setting.
  • The quality of the individual trials.  The reviewers comment on the need for longer term studies that report on type 2 diabetes, cardiovascular outcomes and mortality.


Dunkley AJ, Charles K et al. Effectiveness of interventions for reducing diabetes and cardiovascular disease risk in people with metabolic syndrome: systematic review and mixed treatment comparison meta-analysis. Diabetes Obes Metab. 2012 Jan 27. doi: 10.1111/j.1463-1326.2012.01571.x. [Epub ahead of print]

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I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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