Reversal of Prediabetes in Saudi Adults: Results from an 18 Month Lifestyle Intervention

Amer, Osama E.; Sabico, Shaun; Alfawaz, Hanan; Aljohani, Naji; Hussain, Syed Danish; Alnaami, Abdullah M.; Wani, Kaiser; Al-Daghri, Nasser M.

doi:10.3390/nu12030804

Cited by 30 publications

(25 citation statements)

References 33 publications

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“…25 Most recently, an RCT conducted in Saudi Arabia implementing an 18-months lifestyle changes intervention following the American Diabetes Association (ADA) criteria with similar age and BMI, in addition to the glucose levels 43.4±7.8, 31.3±6.4, and 6.1±0.4, respectively. 26 The study also showed similar results to Tawazon-DPP's outcomes with a significant reduction in body weight, BMI, and glucose/HbA1c. 26 However, the published study team struggled with sustaining the interest of the individuals to implement the needed lifestyle changes.…”

Section: Dovepresssupporting

confidence: 68%

“…26 The study also showed similar results to Tawazon-DPP's outcomes with a significant reduction in body weight, BMI, and glucose/HbA1c. 26 However, the published study team struggled with sustaining the interest of the individuals to implement the needed lifestyle changes. And despite this major limitation of poor compliance from the participants, the study added to the literature clinical value given the ethnic and cultural variations in response to DPPs.…”

Section: Dovepresssupporting

confidence: 68%

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Tawazon- An Intensive Lifestyle Diabetes Prevention Program: The Saudi Arabian Pilot

Mushcab¹,

Alsharif²,

Nazeer³

et al. 2021

JMDH

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Background Lifestyle modification interventions help prevent or postpone Type 2 Diabetes and its complications with diet modification and increasing physical activity. This is translational research of Tawazon-DPP in which we evaluate the efficacy of the intensive lifestyle modification program. Methods Tawazon was piloted in 2 phases over 6 and 9 months at a Tertiary Hospital. Phase I was conducted in 2017 in one district facility with 47 participants while Phase II was conducted in 2018 in 4 district facilities with 247 participants. Data are collected retrospectively in a before-and-after study design. The program included adults with 25 kg/m 2 BMI and HbA1c ranging between 5.7 and 6.4 mmol/L, while excluding participants with comorbidities, such as cardiovascular conditions, musculoskeletal injuries, and pregnancy. Results We used descriptive analysis as well as Wilcoxon rank sign test and McNemar-Bowker for before and after data comparisons. Phase I exhibited a mean age of 43±7 years and statistically significant improvement in HbA1c (0.3 mmol/L), weight (3.3 kg), BMI (1 kg/m 2 ), triglyceride (30.4 mg/dL) and LDL (14.67 mg/dL). Phase II exhibited a mean age of 45±9 years with 70% above 40 years old. Significant improvement was also found in HbA1c (0.2 mmol/L), weight (5.1 kg), and BMI (1.8 kg/m 2 ); the lipid profile in the second phase showed better results with significant improvement in total cholesterol (7.4 mg/dL), triglyceride (20.9 mg/dL), LDL (8.8 mg/dL), and (0.9 mg/dL) increase in HDL. Conclusion This pilot has taken lifestyle interventions to real-life and it led to the favored and desired outcome. It showed that long-term guided support can help patients make the needed changes in their diet, habits, and physical activity, thus, prevent or delay the onset of Type 2 diabetes.

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Section: Dovepresssupporting

confidence: 68%

Section: Dovepresssupporting

confidence: 68%

Tawazon- An Intensive Lifestyle Diabetes Prevention Program: The Saudi Arabian Pilot

Mushcab¹,

Alsharif²,

Nazeer³

et al. 2021

JMDH

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“…DS users make a greater effort to seek health and wellness than non-users. Our recent studies on adults reported significant positive effects on health outcomes like diabetes and metabolic syndrome in interventions that combined approaches like balanced diet and increased physical activities [32][33][34]. Such studies on children and adolescents in this region are limited.…”

Section: Discussionmentioning

confidence: 98%

The Prevalence and Awareness Concerning Dietary Supplement Use among Saudi Adolescents

Alfawaz

Khan

Almarshad

et al. 2020

IJERPH

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Current dietary supplement (DS) use among Saudi school students is not well described. In this study, we aim to investigate the prevalence and predictors of DS use among adolescents. This cross-sectional study collected data via self-administered questionnaire from 1221 students (12 to 18 years). The overall prevalence of DS use was 26.2%, significantly higher in females than males (33% vs. 17.9%, p < 0.001). High proportion of female DS users demonstrated normal BMI than males (84% vs. 56.5%, p < 0.001). High percentage of male DS users were engaged in vigorous and/or high physical activity (PA) levels than female DS users (58.2% vs. 43%, p = 0.022; and 57.1% vs. 20.7%, p < 0.001, respectively). The main reasons for DS use among females were vitamin deficiency (63.3%), hair condition (37.6%) and nail health (23.5%) while in males, the main reasons were vitamin deficiency (58.4%) and body building (34.4%). The predictors of DS use in Saudi adolescents included being female, having high family income and being physically active. In conclusion, the overall prevalence and preference of DS use, though low among Saudi adolescents, was driven mostly by gender, physical activity levels and socioeconomic factors like family income. DS use guidelines and counselling among Saudi adolescents are warranted to improve public health.

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“…Mathematical models predict that pre-diabetes to T2DM conversion occurs at approximately 2.5%/year, with persons of African and Asian descent being at higher risk [ 3 , 43 ]. Pre-diabetes management hinges on weight loss, and a substantial amount of work has investigated the effects of various diets [ 45 , 46 ]. In this study, participants with pre-diabetes were on average, able to surpass the recommended 5% reduction in body weight needed for T2DM risk reduction.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a community-based low-calorie dietary intervention for the induction of type-2 diabetes and pre-diabetes remission: a feasibility study utilising a type 2 hybrid design

Quimby

Sobers

George

et al. 2021

Implement Sci Commun

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Objectives The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training programme to develop the clinical skills needed to support a diabetes remission protocol based on a low-calorie diet (LCD) and (2) investigate if participant weight loss can be achieved and diabetes remission induced under these conditions. Methods This tripartite study followed a type 2 implementation-effectiveness design. Three faith-based organisations (FBOs) were purposively selected as study sites. Implementation outcomes were guided by the Consolidated Framework for Implementation Research. During the pre-implementation phase, site ‘readiness’ to facilitate the intervention was determined from a site visit and an interview with the FBOs’ leadership. During the implementation phase, congregants could volunteer for the 10-week CHA training which included practical exercises in weight, glucose and blood pressure (BP) measurement, and a summative practical assessment. Acceptability and implementation effectiveness were assessed via survey. During the intervention phase, other congregants and community members with T2DM or pre-diabetes and overweight were invited to participate in the 12-week LCD. Anti-diabetic medication was discontinued on day 1 of the intervention. Clinical effectiveness was determined from the change in weight, fasting blood glucose (FBG) and BP which were monitored weekly at the FBO by the CHA. HbA1C was performed at weeks 1 and 12. Results The FBOs were found to be ready as determined by their adequate resources and engagement in health-related matters. Twenty-nine CHAs completed the training; all attained a passing grade at ≥1 clinical station, indicating implementation effectiveness. CHA feedback indicated that the programme structure was acceptable and provided sufficient access to intervention-related material. Thirty-one persons participated in the LCD (11 T2DM:20 pre-diabetes). Mean (95%CI) weight loss was 6.0 kg (3.7 to 8.2), 7.9 kg in males vs 5.7 kg in females; A1C (%) decreased from 6.6 to 6.1, with a greater reduction in those with T2DM when compared to pre-diabetes. FBG decreased from 6.4 to 6.0mmol/L. T2DM remission rates were 60% and 90% by A1C<6.5% and FBG<7mmol/L respectively. Pre-diabetes remission was 18% and 40% by A1C<5.7% and FBG<5.6 respectively. Conclusion Implementation of a community-based diabetes remission protocol is both feasible and clinically effective. Its sustainability is to be determined. Adaptability to other disorders or other settings should be investigated. Trial registration NCT03536377 registered on 24 May 2018.

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Reversal of Prediabetes in Saudi Adults: Results from an 18 Month Lifestyle Intervention

Cited by 30 publications

References 33 publications

Tawazon- An Intensive Lifestyle Diabetes Prevention Program: The Saudi Arabian Pilot

Tawazon- An Intensive Lifestyle Diabetes Prevention Program: The Saudi Arabian Pilot

The Prevalence and Awareness Concerning Dietary Supplement Use among Saudi Adolescents

Implementation of a community-based low-calorie dietary intervention for the induction of type-2 diabetes and pre-diabetes remission: a feasibility study utilising a type 2 hybrid design

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