How Effective Were Lifestyle Interventions In Real-World Settings That Were Modeled On The Diabetes Prevention Program?
ABSTRACT We conducted a systematic review and meta-analysis of twenty-eight US-based studies applying the findings of the Diabetes Prevention Program, a clinical trial that tested the effects of a lifestyle intervention for people at high risk for diabetes, in real-world settings. The average weight change at twelve months after the intervention was a loss of about 4 percent from participants' baseline weight. Change in weight was similar regardless of whether the intervention was delivered by clinically trained professionals or lay educators. Additional analyses limited to seventeen studies with a nine-month or greater follow-up assessment showed similar weight change. With every additional lifestyle session attended, weight loss increased by 0.26 percentage point. We conclude that costs associated with diabetes prevention can be lowered without sacrificing effectiveness, using nonmedical personnel and motivating higher attendance at program sessions.
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ABSTRACT: A myriad of diabetes prevention programs are carried out worldwide to fight against the current type 2 diabetes (T2D) pandemic. The lack of a unified criterion for evaluating the efficacy of T2D prevention programs, however, makes the interpretation of prevention program results difficult, and hinders clear and direct comparisons of different prevention programs. Metabolic syndrome is a strong indicator for diabetes and its complications, holding great promise to become the basis of an intervention evaluation method. The Metabolic Syndrome Index (MSI), proposed here, quantifies the metabolic risk for developing T2D and its complications. The MSI is a novel scale for evaluating the efficacy of diabetes prevention programs because it is a systematic, comprehensive, and stable indicator that reflects the metabolic risk reduction for diabetes and its complications at multiple levels and dimensions.Journal of Diabetes Mellitus 05/2013; 3(2):96-99. DOI:10.4236/jdm.2013.32014
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ABSTRACT: Several efficacy trials and subsequent dissemination studies indicate that behavioral lifestyle interventions for diabetes risk reduction require, at a minimum, provision of 4 to 6 months of frequent intervention contact to induce clinically meaningful weight losses of at least 5% of initial body weight. Weekly contact during the first several months of intervention, followed by less frequent but regular therapeutic contact for a longer time period, appears necessary for participants to adopt and enact behavioral self-regulatory skills such as the self-monitoring of diet, weight, and physical activity and the problem solving of common physical, social, and cognitive barriers that impede sustained weight loss. In-person contact is associated with the largest effect sizes but may not be a necessary component for clinically meaningful weight loss. Regardless of intervention mode, setting, or provider, the interactive process of feedback and social support is crucial for skill development and sustained weight loss.Current Diabetes Reports 02/2012; 12(2):138-46. DOI:10.1007/s11892-012-0256-9 · 3.38 Impact Factor
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ABSTRACT: This review summarizes the current data on diabetes risk factors, prevalence, and prevention efforts in Asia and Asian migrant populations. Studies indicate that type 2 diabetes mellitus is a large and growing threat to public health in Asian populations. Furthermore, Asian subgroups (e.g., South Asians/Asian Indians, Chinese) have unique risk factor profiles for developing diabetes, which differ from other populations and between Asian ethnic groups. Lifestyle intervention programs are effective in preventing diabetes in Asians, as with other ethnicities. The strength of these findings is lessened by the lack of systematically collected data using objective measurements. Large epidemiologic studies of diabetes prevalence and risk factor profiles and translational trials identifying sustainable and culturally acceptable lifestyle programs for Asian subgroups are needed.Annual Review of Nutrition 04/2012; 32:417-39. DOI:10.1146/annurev-nutr-071811-150630 · 10.46 Impact Factor