The healthy living partnerships to prevent diabetes and the diabetes prevention program: a comparison of year 1 and 2 intervention results

Abstract

A number of research studies have attempted to translate the behavioral lifestyle intervention delivered in the Diabetes Prevention Program (DPP). To compare the active interventions of two trials, Diabetes Prevention Program DPP and Healthy Living Partnerships to Prevent Diabetes (HELP PD), after 1 and 2 years of intervention. DPP included 3234 adults with prediabetes randomized to intensive lifestyle intervention, metformin, troglitazone, or placebo. The lifestyle intervention, professionally delivered to individuals in a clinical setting, focused on diet and increased physical activity. HELP PD, a community-based translation of DPP, included 301 adults randomized to receive intensive lifestyle intervention or enhanced usual care. Mean weight-losses at 1 year (6.9 kg in DPP, 6.4 kg in HELP PD) and 2 years (5.5 kg in DPP, 4.4 kg in HELP PD) were similar across studies. Reductions in glucose were also similar across studies at both time points (5.2 mg/dL in DPP and 4.1 mg/dL in HELP PD at 1 year; 1.8 mg/dL and 1.6 mg/dL at 2 years). HELP PD participants achieved larger reductions in triglycerides at 1 and 2 years (38.4 mg/dL and 34.9 mg/dL, respectively) than DPP participants (24.8 mg/dL and 22.4 mg/dL). High-density lipoprotein decreased in HELP PD participants at year 1 (−0.6 mg/dL) and increased in DPP (1.2 mg/dL) but there were no significant differences in year 2. HELP PD, a community model for diabetes prevention, was similar to DPP in reducing body weight and lowering blood glucose, both important risk factors that should be controlled to reduce risk for developing type 2 diabetes.

Long-term Weight Loss Maintenance in the Continuation of a Randomized Diabetes Prevention Translational Study: The Healthy Living Partnerships to Prevent Diabetes (HELP PD) Continuation Trial

“…HELP PD previously reported that participants in the LWL arm of the study experienced statistically significant positive changes in body weight during the intensive 6-month phase (P1) and maintained those changes during the 18-month maintenance phase (P2) compared with the enhanced usual care (EUC) group (13,25). Positive betweengroup differences in fasting blood glucose, waist circumference, and other biological variables also remained relatively consistent over P1 and P2 (13,25) and were comparable to those achieved in the DPP (26).…”

“…Data were collected at baseline and every 6 months to assess changes in key outcome measures. Details regarding the design, recruitment and baseline characteristics, key outcomes, intervention delivery, cost, and a comparison of the HELP PD results with those of the DPP have been published elsewhere (13,(24)(25)(26)(27)(28). Approval to proceed with all phases of HELP PD was received from the institutional review board of Wake Forest University Health Sciences, and study progress was annually reviewed and approved.…”

The 24-month metabolic benefits of the healthy living partnerships to prevent diabetes: A community-based translational study

“…11,12 The cost of the intervention program was approximately one-third that of DPP as HELP PD employed community health workers to facilitate the intervention groups. 13 The intervention resulted in weight loss in most participants in the first 6 months comparable to DPP 14 and the weight loss was maintained in a significant number of participants for a 24 month period. 11,12 This paper summarizes the impact of the intervention on 12 and 24 month changes in the metabolic syndrome and its individual components in these individuals.…”

Public views of different sources of health advice:pharmacists, social media and mobile health applications

“…Today over 4 million people have diabetes; around a quarter of the population are obese (24.3% of men and 26.8% of women); and 2.5 million are living with cancer . These conditions are linked to lifestyle, with lack of exercise and poor diet identified as risk factors …”

“…[3] These conditions are linked to lifestyle, with lack of exercise and poor diet identified as risk factors. [4][5][6] This comes at a time when the National Health Service (NHS) is facing a budget deficit leaving healthcare professionals (HCPs), including community pharmacists (CPs), trying to identify interventions that can tackle lifestylerelated health problems. Patients can access services such as smoking cessation, weight management and seasonal vaccinations from their community pharmacy.…”