Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals

Braver, Nicolette R. den; Vet, Emely de; Duijzer, Geerke; Beek, Josien ter; Jansen, Sophia C; Hiddink, G.J.; Feskens, Edith J. M.; Haveman‐Nies, Annemien

doi:10.1186/s12966-017-0532-9

Cited by 22 publications

(21 citation statements)

References 35 publications

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“…The process evaluation of the SLIMMER study was published by Van Dongen et al (168). Papers have been submitted: on the effect and maintenance of the SLIMMER study (169), on the question of whether the success of the SLIMMER study was modified by socio-economic status (170), on the costeffectiveness of the SLIMMER study (171), on the determinants of lifestyle behaviour change to prevent type 2 diabetes in high-risk persons (172), and a summarizing article in Dutch by Huisarts and Wetenschap (173). The most important message is: SLIMMER is effective in the short and longer term (18 months) in improving clinical and metabolic risk factors, dietary intake, physical activty, and quality of life, of persons at high risk of diabetes.…”

Section: Slimmer Studymentioning

confidence: 99%

Present and future of nutrition guidance : lifestyle advice in primary care

Hiddink¹,

Wass²

2016

Preprint

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Section: Slimmer Studymentioning

confidence: 99%

Present and future of nutrition guidance : lifestyle advice in primary care

Hiddink¹,

Wass²

2016

Preprint

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“…Texeira et al found that motivation, self-e cacy, and self-regulation skills were reported as mediators of weight change and physical activity behavior [44]. Den Braver et al also reported that SLIMMER (SLIM iMplementation Experience Region Noord-en Oost-Gelderland) intervention on fasting insulin and body weight was mediated by changes in dietary and physical activity behavior [45]. Mediation models identify and explain the process that underlies an observed relationship between an independent variable (diabetes knowledge) and a dependent variable (glycemic control) via the inclusion of a third hypothetical variable, known as a mediator variable (i.e., self-care behaviors.…”

Section: Discussionmentioning

confidence: 99%

Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

Silva-Tinoco¹,

Cuatecontzi-Xochitiotzi²,

Torre-Saldaña³

et al. 2020

Preprint

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Background Although important achievements have been done in type 2 diabetes mellitus (T2D) treatment and glycemic control, new strategies may take advantage of non-pharmacological approaches and of other potential determinants of health (e.g., socioeconomic status, education, diabetes knowledge, physical activity, and self-care behavior). However, the relationships between these factors are not totally clear and have not been studied in the context of large urban settings. This study aimed to explore the relationship between these determinants of glycemic control (GC) in a low-income urban population from Mexico City, focused in exploring potential the mediation of self-care behaviors in the association between diabetes knowledge and GC.Methods A multicenter cross-sectional study was conducted in patients with type 2 diabetes (T2D) from 28 primary care outpatient centers located in Mexico City. Using multivariable-adjusted models, we determined the associations between diabetes knowledge, self-care behaviors, and GC. The mediation analyses to determine the pathways on glycemic control were done using linear regression models, where the significance of indirect effects was calculated with bootstrapping.Results The population (N=513) had a mean age of 53.8 years (standard deviation: 11.3 yrs.), and 65.9% were women. Both socioeconomic status and level of education were directly associated with diabetes knowledge. Using multivariable-adjusted linear models, we found that diabetes knowledge was associated with GC (β: -0.102, 95% Confidence Interval [95% CI] -0.189, -0.014). Diabetes knowledge was also independently associated with self-care behavior (for physical activity: β: 0.181, 95% CI 0.088, 0.273), and self-care behavior was associated with GC (for physical activity: β: -0.112, 95% CI -0.194, -0.029). The association between diabetes knowledge and GC was not observed after adjustment for self-care behaviors, especially physical activity (β: -0.084, 95% CI -0.182, 0.014, p-value: 0.062). Finally, the mediation models showed that the effect of diabetes knowledge on GC was 17% independently mediated by physical activity (p-value: 0.049). Conclusions Socioeconomic and educational gradients influence diabetes knowledge among primary care patients with type 2 diabetes. Self-care activities, particularly physical activity, mediated the effect of diabetes knowledge on GC. Our results indicate that diabetes knowledge should be reinforced in low-income T2D patients, with an emphasis on the benefits physical activity has on improving GC.

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“…Furthermore, the overall dropout rate after allocation into both intervention groups was small (247:285; 13%) and not different (S-group = 12% and M-group = 14%). We hypothesize that the strict rules, the stringent and individual SMBG [ 17 ], and the complete replacement of all meals in the S-group during the first week contributed to a subtler change of behavior and higher motivation for the diet, which was shown to be necessary for long-term changes of behavior in high-risk individuals for type 2 diabetes in prior studies [ 19 ]. Furthermore, we assume that our personalized nutrition and treatment-approach with a more intense patient empowerment during the first week in the S-group contributed to a long-term difference in HbA1c after 52 weeks of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients

Kempf¹,

Röhling²,

Niedermeier³

et al. 2018

Nutrients

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Background Formula diets can improve glycemic control or can even induce remission in type 2 diabetes. We hypothesized that especially an individualized intense meal replacement by a low-carbohydrate formula diet with accompanied self-monitoring of blood glucose (SMBG) contributes to long-term improvements in HbA1c, weight, and cardiometabolic risk factors in poorly controlled type 2 diabetes. Methods Type 2 diabetes patients were randomized into either a moderate group (M-group) with two meal replacements/day (n = 160) or a stringent group (S-group) with three meal replacements/day (n = 149) during the first week of intervention (1300–1500 kcal/day). Subsequently, both groups reintroduced a low-carbohydrate lunch based on individual adaption due to SMBG in weeks 2–4. After week 4, breakfast was reintroduced until week 12. During the follow-up period, all of the participants were asked to continue replacing one meal per day until the 52-weeks follow-up. Additionally, an observational control group (n = 100) remained in routine care. Parameters were compared at baseline, after 12 and 52 weeks within and between all of the groups. Results 321 participants (83%) completed the acute meal replacement phase after 12 weeks and 279 participants (72%) the whole intervention after 52 weeks. Both intervention groups achieved improvements in HbA1c, fasting blood glucose, blood pressure, and weight (all p < 0.001) within 12 weeks. However, these results were not significantly different between both of the intervention groups. The estimated treatment difference in HbA1c reduction was (mean (95% confidence interval [CI]) -0.10% with 95% CI [−0.40; 0.21] also (p > 0.05) (S-group vs. M-group) not statistically different after 12 weeks. However, only the S-group showed a clinically relevant improvement in HbA1c of −0.81% [−1.06; −0.55] (p < 0.001) after 52 weeks of follow-up, whereas HbA1c was not statistically different between the M- and control group. Conclusion Individualized meal replacement with SMBG demonstrated beneficial effects on HbA1c and cardiometabolic parameters in type 2 diabetes. Furthermore, the initiation of a weight loss program with one week of full meal replacement (three meals per day) resulted in a clinically relevant long-term HbA1c reduction, as compared to an observational control group that had standard care.

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Determinants of lifestyle behavior change to prevent type 2 diabetes in high-risk individuals

Cited by 22 publications

References 35 publications

Present and future of nutrition guidance : lifestyle advice in primary care

Present and future of nutrition guidance : lifestyle advice in primary care

Influence of social determinants, diabetes knowledge, health behaviors, and glycemic control in type 2 diabetes: An analysis from real-world evidence

Individualized Meal Replacement Therapy Improves Clinically Relevant Long-Term Glycemic Control in Poorly Controlled Type 2 Diabetes Patients

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