The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study

Li, Guangwei; Zhang, Ping; Wang, Jinping; Gregg, Edward W.; Yang, Wenying; Gong, Qi; Li, Hui; Li, Hongliang; Jiang, Yu; An, Yi; Shi, Ying; Zhang, Bo; Zhang, Jingling; Thompson, Theodore; Gerzoff, Robert B.; Roglić, Gojka; Hu, Yinghua; Bennett, Peter H.

doi:10.1016/s0140-6736(08)60766-7

Cited by 1,371 publications

(1,028 citation statements)

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“…The landmark Diabetes Prevention Program (DPP) showed that a lifestyle intervention facilitating a 7% weight loss had a significantly greater impact on diabetes risk than placebo or metformin with a risk reduction of 58% over 3 years [3]. Similar findings were reported in diabetes prevention studies in Finland and China [4,5]. The impact of lifestyle interventions appears to be long term [3,4].…”

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confidence: 84%

“…In the 10-year follow-up of the DPP, the incidence of diabetes in the placebo and metformin groups (who had been offered the lifestyle intervention following the initial intervention period) fell to equal that of the lifestyle group; however, the cumulative incidence of diabetes remained lowest in the lifestyle group [6]. The China Da Qing Study revealed reduced incidence of diabetes from a lifestyle intervention at 20-year follow-up [5]. Widespread availability of lifestyle interventions could have a tremendous impact on public health.…”

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confidence: 99%

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The current state of lifestyle intervention implementation research: where do we go next?

Pagoto

2011

Behav. Med. Pract. Policy Res.

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In the USA, the prevalence of obesity is 33.8% [1] and type 2 diabetes is 27% [2]. The landmark Diabetes Prevention Program (DPP) showed that a lifestyle intervention facilitating a 7% weight loss had a significantly greater impact on diabetes risk than placebo or metformin with a risk reduction of 58% over 3 years [3]. Similar findings were reported in diabetes prevention studies in Finland and China [4,5]. The impact of lifestyle interventions appears to be long term [3,4]. In the 10-year follow-up of the DPP, the incidence of diabetes in the placebo and metformin groups (who had been offered the lifestyle intervention following the initial intervention period) fell to equal that of the lifestyle group; however, the cumulative incidence of diabetes remained lowest in the lifestyle group [6]. The China Da Qing Study revealed reduced incidence of diabetes from a lifestyle intervention at 20-year follow-up [5]. Widespread availability of lifestyle interventions could have a tremendous impact on public health.In 2003, the United States Preventive Services Task Force assigned intensive lifestyle weight loss interventions, a B grade based on a review of the literature, with fair to good evidence for modest, sustained weight loss [7]. In spite of the evidence, intensive lifestyle interventions have not become a part of standard health care practice and are not a third party reimbursable service, with only a few exceptions. A significant barrier to large-scale adoption is the feasibility of translating intensive lifestyle intervention into real world settings. The DPP lifestyle intervention cost US $2,780 per person over 3 years and required 135 visit hours [8]. Although the cost was not significantly higher than the metformin group, visit time was 3.5 times higher. The amount of visit time is high relative to most services available in the current health care environment. To impact public health, research is needed to inform the process of translation and implementation of intensive lifestyle interventions into affordable, feasible, and sustainable programs not just in healthcare settings but also in community settings such as community centers, worksites, schools, and churches. To catalyze translational research efforts, in 2006, the National Institute for Diabetes and Digestive and Kidney Diseases sponsored a funding initiative for translational research in diabetes prevention and management. Since then, translational work across myriad settings has been forthcoming. In 2009, a systematic review was performed of the seven studies testing translation into community settings of lifestyle interventions specifically based on the DPP [9]. All reported significant weight loss; however, weight loss achieved (2.6-6%) was typically less than that in the DPP (6.9%). Only three examined 1-year outcomes, but all three had significant weight loss at 1 year. I recently surveyed the authors of these seven programs and found that only two were confirmed to be ongoing, one in a hospital setting [10] and the other in the Young Men's...

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confidence: 84%

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The current state of lifestyle intervention implementation research: where do we go next?

Pagoto

2011

Behav. Med. Pract. Policy Res.

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“…These have had a particularly large impact in China, but these are modifiable factors. That eating a healthy diet and becoming physically more active can prevent diabetes has been convincingly proven by China’s Daqing Impaired Glucose Tolerance and Diabetes Study 3 . These findings underline that developing education models calling for the general public to adopt healthy lifestyles is significant for reducing the diabetes epidemic in the future.…”

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confidence: 87%

Diabetes in China: The challenge now

Weng¹,

2010

J of Diabetes Invest

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“…After 6 years of follow-up, all three interventions were similarly effective, with risk reductions of 31-46 % compared to the control group. A recent long-term follow-up shows that the reduction in the 20-year cumulative incidence in the intervention groups (80 vs 93 % in the control group) [62] is paralleled by a reduction in the long-term cumulative incidence of CVD mortality (11.9 % in the intervention group vs 19.6 % in the control group, HR 0.59; 95 % CI 0.36-0.96; p = 0.033) and all-cause mortality (28.1 vs 38.4, HR 0.71; 95 % CI 0.51-0.99; p = 0.049) [62]. These data are the first available showing the impact on mortality of lifestyle intervention and are of great value in a country where 40 % of subjects aged 19-29 years were recently found to have a blood glucose level in the range of pre-diabetes [63].…”

Section: Lifestyle Interventions and Prevention Of Type 2 Diabetes Inmentioning

confidence: 98%

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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The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study

Cited by 1,371 publications

References 21 publications

The current state of lifestyle intervention implementation research: where do we go next?

The current state of lifestyle intervention implementation research: where do we go next?

Diabetes in China: The challenge now

Lifestyle interventions in preventing new type 2 diabetes in Asian populations

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