Can the onset of type 2 diabetes be delayed by a group-based lifestyle intervention? A randomised control trial

Moore, Susan; Hardie, Elizabeth A.; Hackworth, Naomi; Critchley, Christine; Kyrios, Michael; Buzwell, Simone; Crafti, Naomi

doi:10.1080/08870440903548749

Cited by 45 publications

(89 citation statements)

References 23 publications

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“…Allocation concealment was low risk in 2 studies [20, 24], where telephone calls or numerical values were given to denote the study group. One study was high risk [21], where participants had knowledge of their allocation to the intervention group.…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…For 3 of the studies, it was unclear if the participants and personnel were blinded [20, 23, 25]. The remaining 4 studies did not blind participants or personnel [19, 22], with 2 studies specifically stating that participants are told what the intended intervention is for [18, 21].…”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…It was unclear in the remaining 6 studies whether the outcome assessors were blinded or not [17–20, 23, 25]. …”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…Two studies are from Japan [24] and Kosaka et al, 2002, and each of the following countries was represented by one study 1: USA [17], Finland [19], Australia [20], England [21], India [22], Netherlands [23], and China [25]. …”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

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The Effectiveness of Lifestyle Adaptation for the Prevention of Prediabetes in Adults: A Systematic Review

Kerrison

Gillis

Jiwani

et al. 2017

Journal of Diabetes Research

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Diabetes prevalence is increasing exceptionally worldwide and with this come associated healthcare costs. The primary outcome of this systematic review was to assess glycaemic control and incidence of Type 2 diabetes mellitus (T2DM) diagnosis after exercise and dietary intervention (measured with any validated scale). The secondary outcome assessed body mass index change, weight change, and physical exercise capacity after diet and exercise intervention (measured with any validated scale). 1,780 studies were identified from searching electronic databases. Relevant studies went through a selection process. The inclusion criteria for all studies were people with prediabetes diagnosed by either impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). Lifestyle adaptation reduced the incidence of diabetes development more than standard treatment. Furthermore, better glycaemic control, improved physical exercise capacity, and increased weight reduction were observed with lifestyle intervention over standard treatment. Finally, improvements over the long term deteriorated, highlighting problems with long-term adherence to lifestyle changes. Overall, cumulative incidence of diabetes is drastically reduced in the intervention groups compared to control groups (standard care). Furthermore, glycaemic control was improved in the short term, with many participants reverting to normoglycaemia.

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Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

“…It was unclear in the remaining 6 studies whether the outcome assessors were blinded or not [17–20, 23, 25]. …”

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

Section: Risk Of Bias In Included Studiesmentioning

confidence: 99%

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The Effectiveness of Lifestyle Adaptation for the Prevention of Prediabetes in Adults: A Systematic Review

Kerrison

Gillis

Jiwani

et al. 2017

Journal of Diabetes Research

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“…has a direct lineage from the Finnish Diabetes Prevention Study (DPS) (2), Good Ageing in Lahti Region (GOAL) Implementation Trial (9), and GGT DPP (4,10). Additionally, the Department of Health Victoria had experience of its Healthy Living Course DPP (11). Life!…”

Section: Establishing a Statewide Prevention Program In Victoriamentioning

confidence: 99%

Scaling Up Diabetes Prevention in Victoria, Australia: Policy Development, Implementation, and Evaluation

Dunbar¹,

Jayawardena²,

Johnson

et al. 2014

Diabetes Care

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OBJECTIVEThe Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This article describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation. RESEARCH DESIGN AND METHODSLife!, a behavior-change intervention, comprises six group sessions over 8 months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training, and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, were recorded on a central database. RESULTSLife! has a statewide workforce of 302 trained facilitators within 137 organizations. Over 29,000 Victorians showed interest in Life!, and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011, and 37% of the original participants completed the 8-month program. Participants completing sessions 1 to 5 lost an average of 1.4 kg weight (P < 0.001) and waist circumference of 2.5 cm (P < 0.001). Those completing six sessions lost an average of 2.4 kg weight (P < 0.001) and waist circumference of 3.8 cm (P < 0.001). The weight loss of 2.4 kg represents 2.7% of participants' starting body weight. CONCLUSIONSThe impact of Life! is attributable to applying available evidence for the system's design of the intervention and collaboration between policy makers, implementers, and evaluators using the principles of continuous quality improvement to support successful, large-scale recruitment and implementation.

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Long-term Sustainability of Diabetes Prevention Approaches

et al. 2017

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IMPORTANCE Diabetes prevention is imperative to slow worldwide growth of diabetes-related morbidity and mortality. Yet the long-term efficacy of prevention strategies remains unknown.OBJECTIVE To estimate aggregate long-term effects of different diabetes prevention strategies on diabetes incidence.DATA SOURCES Systematic searches of MEDLINE, EMBASE, Cochrane Library, and Web of Science databases. The initial search was conducted on January 14, 2014, and was updated on February 20, 2015. Search terms included prediabetes, primary prevention, and risk reduction.STUDY SELECTION Eligible randomized clinical trials evaluated lifestyle modification (LSM) and medication interventions (>6 months) for diabetes prevention in adults (age Ն18 years) at risk for diabetes, reporting between-group differences in diabetes incidence, published between January 1, 1990, and January 1, 2015. Studies testing alternative therapies and bariatric surgery, as well as those involving participants with gestational diabetes, type 1 or 2 diabetes, and metabolic syndrome, were excluded. DATA EXTRACTION AND SYNTHESISReviewers extracted the number of diabetes cases at the end of active intervention in treatment and control groups. Random-effects meta-analyses were used to obtain pooled relative risks (RRs), and reported incidence rates were used to compute pooled risk differences (RDs). MAIN OUTCOMES AND MEASURESThe main outcome was aggregate RRs of diabetes in treatment vs control participants. Treatment subtypes (ie, LSM components, medication classes) were stratified. To estimate sustainability, post-washout and follow-up RRs for medications and LSM interventions, respectively, were examined. RESULTS Forty-three studies were included and pooled in meta-analysis (49 029 participants; mean [SD] age, 57.3 [8.7] years; 48.0% [n = 23 549] men): 19 tested medications; 19 evaluated LSM, and 5 tested combined medications and LSM. At the end of the active intervention (range, 0.5-6.3 years), LSM was associated with an RR reduction of 39% (RR, 0.61; 95% CI, 0.54-0.68), and medications were associated with an RR reduction of 36% (RR, 0.64; 95% CI, 0.54-0.76). The observed RD for LSM and medication studies was 4.0 (95% CI, 1.8-6.3) cases per 100 person-years or a number-needed-to-treat of 25. At the end of the washout or follow-up periods, LSM studies (mean follow-up, 7.2 years; range, 5.7-9.4 years) achieved an RR reduction of 28% (RR, 0.72; 95% CI, 0.60-0.86); medication studies (mean follow-up, 17 weeks; range, 2-52 weeks) showed no sustained RR reduction (RR, 0.95; 95% CI, 0.79-1.14). CONCLUSIONS AND RELEVANCEIn adults at risk for diabetes, LSM and medications (weight loss and insulin-sensitizing agents) successfully reduced diabetes incidence. Medication effects were short lived. The LSM interventions were sustained for several years; however, their effects declined with time, suggesting that interventions to preserve effects are needed.

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Can the onset of type 2 diabetes be delayed by a group-based lifestyle intervention? A randomised control trial

Cited by 45 publications

References 23 publications

The Effectiveness of Lifestyle Adaptation for the Prevention of Prediabetes in Adults: A Systematic Review

The Effectiveness of Lifestyle Adaptation for the Prevention of Prediabetes in Adults: A Systematic Review

Scaling Up Diabetes Prevention in Victoria, Australia: Policy Development, Implementation, and Evaluation

Long-term Sustainability of Diabetes Prevention Approaches

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