Effectiveness of prediabetes nutrition shared medical appointments: prevention of diabetes

Diabetes Educ. 2013 May-Jun;39(3):344-53. doi: 10.1177/0145721713484812. Epub 2013 Apr 15.


Purpose: The purpose of this study is to evaluate the effectiveness of a nutrition-based shared medical appointment (SMA) intervention in the treatment of prediabetes compared to the individualized counseling standard of care.

Methods: A randomized controlled trial design comparing health outcomes in patients with prediabetes attending either an individualized counseling (control group) or three 90-minute nutrition SMA (intervention group) sessions. Demographic, anthropometric (weight and body mass index), clinical (blood pressure), and biochemical (lipid profile, fasting blood sugar, glycated hemoglobin, albumin-to-creatinine ratio) measures were obtained from all participants at baseline, at 3 months, and at 1 year.

Results: Ninety-four participants were randomized into the 2 study groups with a 69% completion rate at 1 year (n = 34 SMA, n = 31 control). The average participant was Caucasian (64%), male (54%), 58.3 ± 9.6 years, had a BMI of 30.8 ± 4.9 kg/m(2) (obese), and fasting blood glucose of 109 ± 9.5 mg/dL. The SMA and control participants lost a mean of 6.6 pounds and 3.6 pound, respectively; neither group met the 5% modest weight loss expected. The SMA and control group experienced a mean drop in fasting blood glucose of 6 mg/dL.

Conclusions: As demands on health care providers continue to rise, finding innovative ways to manage the patient load while providing quality health care is increasingly important. SMA health outcomes were equivalent to individual counseling outcomes, while increasing the provider's productivity by treating 6 to 8 people with prediabetes in 90 minutes compared to 1 patient in 60 minutes.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Appointments and Schedules*
  • Blood Glucose
  • Body Mass Index
  • Body Weight
  • Counseling
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Disease Progression
  • Female
  • Focus Groups
  • Glycated Hemoglobin / metabolism
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Nutritional Status
  • Prediabetic State / epidemiology
  • Prediabetic State / physiopathology
  • Prediabetic State / prevention & control*
  • Prevalence
  • Prognosis
  • Texas / epidemiology


  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human