No abstract

We have assessed the impact of a 2-year pilot church-base diabetes risk reduction programme on major lifestyle predictors of future Type 2 diabetes mellitus: exercise and weight control in a prospective non-randomized controlled study of a modular lifestyle and diabetes awareness intervention programme using a community development model. The study involved two complete church congregations from an ethnic group at high risk of diabetes (Western Samoans) (intervention church n = 78; control church n = 144). Weight remained stable (0 ± 4.8 kg) in the intervention church but increased by 3.1 ± 9.8 kg in the control church (p = 0.05). In the intervention church, there was an associated reduction in waist circumference (−4 ± 10 cm vs +2 ± 7 cm in control, p Ͻ Ͻ Ͻ 0.001), an increase in diabetes knowledge (46 ± 26 % vs 4 ± 17 % in control, p Ͻ Ͻ Ͻ 0.001) and an increase in the proportion exercising regularly (+22 % vs −8 % in control, p Ͻ Ͻ Ͻ 0.05). Consumption of key fatty foods was also reduced in the intervention church. We conclude that diabetes risk reduction programmes based upon lifestyle change, diabetes awareness, and empowerment of high risk communities can significantly reduce risk factors for future Type 2 diabetes.

OBJECTIVE: To describe the prevalence of default from diabetes care and to reveal associated characteristics among patients with known diabetes in urban South Auckland, New Zealand. RESEARCH DESIGN AND METHODS: We developed a cross-sectional household study of patients with known diabetes and compared those patients with and without ongoing care. Ongoing care was defined as having been clinically reviewed at least once in the previous 10 months. RESULTS: Of the 1,488 European, Maori, and Pacific Islander subjects with known diabetes, 107 (6.3%) had not seen a general practitioner or a diabetes service in the previous 10 months. Subjects not attending a diabetes service were more likely than subjects attending a diabetes service to have been diagnosed when screened asymptomatically (11.7 vs. 5.2%, P = 0.008) and after gestational diabetes (39.7 vs. 11.7%, P < 0.001). Maori were most likely to have no ongoing care (10.8 vs. 5.8% European and 6.6% of Pacific Islander subjects, P = 0.01). Nonattenders were younger, were diagnosed at a younger age, knew less about diabetes, were less satisfied with past care, and were less likely to require medication. CONCLUSIONS: The elevated number of diabetic individuals not attending ongoing care is a significant problem in this population, and it may reflect a decisional balance as seen in problem behaviors. Diagnosis when asymptomatic may contribute to default from ongoing care; in this case, caution is required if population-based screening programs are being considered.

We have assessed the impact of a 2‐year pilot church‐base diabetes risk reduction programme on major lifestyle predictors of future Type 2 diabetes mellitus: exercise and weight control in a prospective non‐randomized controlled study of a modular lifestyle and diabetes awareness intervention programme using a community development model. The study involved two complete church congregations from an ethnic group at high risk of diabetes (Western Samoans) (intervention church n = 78; control church n = 144). Weight remained stable (0 ± 4.8 kg) in the intervention church but increased by 3.1 ± 9.8 kg in the control church (p = 0.05). In the intervention church, there was an associated reduction in waist circumference (−4 ± 10 cm vs +2 ± 7 cm in control, p < 0.001), an increase in diabetes knowledge (46 ± 26 % vs 4 ± 17 % in control, p < 0.001) and an increase in the proportion exercising regularly (+22 % vs −8 % in control, p < 0.05). Consumption of key fatty foods was also reduced in the intervention church. We conclude that diabetes risk reduction programmes based upon lifestyle change, diabetes awareness, and empowerment of high risk communities can significantly reduce risk factors for future Type 2 diabetes. © 1998 John Wiley & Sons, Ltd.

The mother is a more important conduit for inheritance of diabetes than the father in these three ethnic groups. A history of diabetes in pregnancy confers an extra risk to the offspring above this usual maternal excess.