The Healthy Living Partnerships to Prevent Diabetes study: 2-year outcomes of a randomized controlled trial

Am J Prev Med. 2013 Apr;44(4 Suppl 4):S324-32. doi: 10.1016/j.amepre.2012.12.015.

Abstract

Background: Since the Diabetes Prevention Project (DPP) demonstrated that lifestyle weight-loss interventions can reduce the incidence of diabetes by 58%, several studies have translated the DPP methods to public health-friendly contexts. Although these studies have demonstrated short-term effects, no study to date has examined the impact of a translated DPP intervention on blood glucose and adiposity beyond 12 months of follow-up.

Purpose: To examine the impact of a 24-month, community-based diabetes prevention program on fasting blood glucose, insulin, insulin resistance as well as body weight, waist circumference, and BMI in the second year of follow-up.

Design: An RCT comparing a 24-month lifestyle weight-loss program (LWL) to an enhanced usual care condition (UCC) in participants with prediabetes (fasting blood glucose=95-125 mg/dL). Data were collected in 2007-2011; analyses were conducted in 2011-2012.

Setting/participants: 301 participants with prediabetes were randomized; 261 completed the study. The intervention was held in community-based sites.

Intervention: The LWL program was led by community health workers and sought to induce 7% weight loss at 6 months that would be maintained over time through decreased caloric intake and increased physical activity. The UCC received two visits with a registered dietitian and a monthly newsletter.

Main outcome measures: The main measures were fasting blood glucose, insulin, insulin resistance, body weight, waist circumference, and BMI.

Results: Intent-to-treat analyses of between-group differences in the average of 18- and 24-month measures of outcomes (controlling for baseline values) revealed that the LWL participants experienced greater decreases in fasting glucose (-4.35 mg/dL); insulin (-3.01 μU/ml); insulin resistance (-0.97); body weight (-4.19 kg); waist circumference (-3.23 cm); and BMI (-1.40), all p-values <0.01.

Conclusions: A diabetes prevention program administered through an existing community-based system and delivered by community health workers is effective at inducing significant long-term reductions in metabolic indicators and adiposity.

Trial registration: ClinicalTrials.gov NCT00631345.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity
  • Aged
  • Blood Glucose
  • Body Mass Index
  • Community Health Services / methods*
  • Diabetes Mellitus, Type 2 / etiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Insulin Resistance
  • Life Style*
  • Male
  • Middle Aged
  • Prediabetic State / therapy*
  • Time Factors
  • Treatment Outcome
  • Waist Circumference
  • Weight Loss
  • Weight Reduction Programs / methods

Substances

  • Blood Glucose

Associated data

  • ClinicalTrials.gov/NCT00631345