Three decades after a trial of diet and exercise in those with glucose intolerance, patients are still reaping big benefits, leading to a call to roll out lifestyle programs for type 2 diabetes prevention worldwide.

The Da Qing Diabetes Prevention Outcome study is a classic in the medical literature, say the University of Glasgow authors of an editorial in the Lancet Diabetes and Endocrinology.

It shows, alongside other research, that it is clear “type 2 diabetes should no longer be considered an endocrine disease, the awkward cousin of type 1 disease” and that “type 2 diabetes is a primary nutritional disease”, say Professor Mike Lean and Professor Naveed Sattar.

The study began in 1986 in Da Qing, China, when 438 people were allocated to one of three lifestyle programs and 138 to a normal care control group.