Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

Bhopal, Raj; Douglas, Anne; Wallia, Sunita; Forbes, John F.; Lean, Michael E. J.; Gill, Jason M.R.; McKnight, John; Sattar, Naveed; Sheikh, Aziz; Wild, Sarah H.; Tuomilehto, Jaakko; Sharma, Anu Rani; Smith, Jeffery S.; Butcher, Isabella; Murray, Gordon D.

doi:10.1016/s2213-8587(13)70204-3

Cited by 132 publications

(222 citation statements)

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“…To date there has been a dearth of evidence concerning T2DM prevention in the UK, with small-scale projects showing mixed results. (7)(8)(9)(10) This study assesses whether the Let's Prevent T2DM programme is effective at preventing progression to T2DM in people with PDM identified through a systematic screening pathway within primary care. Let's Prevent is a pragmatic, relatively low resource, group-based structured-education programme targeting lifestyle behaviour change specifically designed for implementation within a community setting.…”

Section: Usa Diabetes Prevention Program (Dpp)(6)mentioning

confidence: 99%

A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial

Davies

Gray

Troughton

et al. 2016

Preventive Medicine

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Aims: Prevention of type 2 diabetes (T2DM) is a priority in healthcare, but there is a lack of evidence investigating how to effectively translate prevention research into a UK primary care setting. We assessed whether a structured education programme targeting lifestyle and behaviour change was effective at preventing progression to T2DM in people with prediabetes.. Materials and methods:44 General Practices were randomised to receive either standard care or a six hour group structured education programme with an annual refresher course, and regular phone contact. Participants were followed up for 3 years. The primary outcome was progression to T2DM.Results: Eight hundred and eighty participants were included (36% female, mean age 64 years, 16% ethnic minority group); 131 participants developed T2DM. There was a nonsignificant 26% reduced risk of developing T2DM in the intervention arm compared to standard care (HR 0.74, 95%CI 0.48, 1.14, p=0.18). The reduction in T2DM risk when excluding those who did not attend the initial education session was also non-significant (HR 0.65, 0.41, 1.03, p=0.07). There were statistically significant improvements in HbA1c (-0.06, -0.11, -0.01), LDL cholesterol (-0.08, -0.15, -0.01), sedentary time (-26.29, -45.26, -7.32) and step count (498.15, 162.10, 834.20) when data were analysed across all time points. Conclusions:This study suggests that a relatively low resource, pragmatic diabetes prevention programme resulted in modest benefits to biomedical, lifestyle and psychosocial outcomes, however the reduction to the risk of T2DM did not reach significance. The findings have important implications for future research and primary care.Trial Registration: ISRCTN80605705

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Section: Usa Diabetes Prevention Program (Dpp)(6)mentioning

confidence: 99%

A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial

Davies

Gray

Troughton

et al. 2016

Preventive Medicine

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“…Eight randomized controlled clinical trials studies evaluated diet and physical activity interventions in Asian adults [2,5,6,[55][56][57][58][59]. The main characteristics of the included studies are reported in Table 1.…”

Section: Lifestyle Interventions and Prevention Of Type 2 Diabetes Inmentioning

confidence: 99%

“…All T2DM prevention trials performed in Asian populations have been based on a high-risk status defined by blood tests. In all studies, the inclusion criteria indeed required IGT, assessed with oral glucose tolerance test (OGTT), or IFG [2,5,6,[55][56][57][58][59]. All eight RCTs were suitable for inclusion in the meta-analysis showing a a 45 % reduction in the incidence of new T2DM in Asian subjects assigned to the intervention arm (OR 0.55; 95 % CI 0.44-0.70) (Fig.…”

Section: Lifestyle Interventions and Prevention Of Type 2 Diabetes Inmentioning

confidence: 99%

“…The first study investigating the effects of lifestyle modifications on progression to T2DM in South Asians (Indian or Pakistani) living in the UK was recently performed by Bhopal et al [59]. Subjects aged 35 years or older, with waist circumference 90 cm or greater in men or 80 cm or greater in women (n = 1319), were screened by oral glucose tolerance test; 196 (15 %) had IGT or IFG and 171 entered the trial and were randomized to intervention (78 families with 85 participants) or control (78 families with 86 participants).…”

Section: Fig 2 Odds Ratio For the Reduction Of Type 2 Diabetes In Ramentioning

confidence: 99%

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Lifestyle interventions in preventing new type 2 diabetes in Asian populations

Modesti

Galanti

Calà³

et al. 2015

Intern Emerg Med

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The aim of this study was to review current evidence on interventional studies aimed at the prevention of type 2 diabetes in Asian population with lifestyle interventions. Prevalence of type 2 diabetes sharply increased in most Asian countries during the last decades. This issue has now also relevant implication for Europe where different surveys are also consistently revealing an higher prevalence of type 2 diabetes and other and major CVD risk factors among subjects originating from Asian Countries than in the native population. Nutrition and lifestyle transition seem to play a role in disclosing the predisposition for the development of type 2 diabetes and great interest is now shown toward the possibility to intervene with lifestyle intervention on at risk populations. A meta-analysis of Randomized Controlled Trials showed that lifestyle interventions are highly effective also in the Asian population. All studies were, however, conducted with an individual approach based on the identification of high-risk individuals. When ethnic minority groups have to be addressed, an approach directed to the community rather than to the individual might, however, be more effective. This review reinforces the importance for policy-makers to consider the involvement of the whole community of minority immigrant groups with lifestyle intervention programs.

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“…In particular, low level of recruitment, retention and follow up of 'high risk' participants has hampered efforts to screen individuals from SA groups [10,11]. In addition to this, lifestyle interventions are often not sufficiently culturally tailored or are not informed by theoretical models and as a result, the methodological quality of relevant studies is often low [12].…”

Section: Introductionmentioning

confidence: 99%

A community faith centre based screening and educational intervention to reduce the risk of type 2 diabetes: A feasibility study

Willis

Mahdavi-Roshan

Patel

et al. 2016

Diabetes Research and Clinical Practice

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Highlights: This study presents novel data on screening yield for diabetes and impaired glucose regulation and uptake to group education to reduce diabetes risk delivered within a faith center setting. This addresses an unmet need for high quality studies assessing this method of screening and education  The data on screening yield and uptake is relevant to the current debate on design and implementation of diabetes prevention programs.  The study presents data describing the performance of a risk assessment score for identifying undiagnosed diabetes and impaired glucose regulation when used in a South Asian population.2 Aims: People of South Asian origin experience higher rates of diabetes and complications of diabetes compared to white Europeans. Therefore, it is important to identify those with undiagnosed diabetes and those at high risk of developing diabetes, in order to intervene with lifestyle intervention to reduce risk and prevent complications. We conducted a study to assess the feasibility of delivering a faith centre based pathway for screening and referral to group education for high risk individuals to increase screening uptake and reduce diabetes risk. Methods:Opportunistic screening and early intervention strategy for people at risk of diabetes and cardiovascular disease in local faith centres. The screening consisted of a diabetes risk assessment tool and a near patient test for HbA1c. Participants found to be at high risk of diabetes (HbA1c 6-6.4%/42-46mmol/mol) were offered a 'walking away from diabetes' group educational intervention aimed at increasing exercise levels and reducing diabetes risk.Results: 252 participants were screened during four screening events. 202 participants (80.2%) gave consent for their data to be included in the analysis. 72.4% of participants were found to have a high diabetes risk score. 32 participants (15.8%) had a HbA1c result 6%-6.4%/42-46mmol/mol). Eight participants (4.0%) had a HbA1c ≥6.5%/≥47mmol/mol). Of those eligible for the diabetes prevention education programme, 18 participants (56.3%) attended. Conclusions:This study confirms that screening followed by group education within faith centre settings is feasible and acceptable to participants. The strategies chosen were effective in achieving a high screening yield and high uptake of group education.

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Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial

Abstract: National Prevention Research Initiative, NHS Research and Development; NHS National Services Scotland; NHS Health Scotland.

Cited by 132 publications

References 33 publications

A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial

A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial

Lifestyle interventions in preventing new type 2 diabetes in Asian populations

A community faith centre based screening and educational intervention to reduce the risk of type 2 diabetes: A feasibility study

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