The Effect Of Metformin And Intensive Lifestyle Intervention On The Metabolic Syndrome: The Diabetes Prevention Program Randomized Trial Free
Author, Article, and Disclosure Information From the Diabetes Prevention Program Coordinating Center, The Biostatistics Center, George Washington University, Rockville, Maryland. Grant Support: Funding was provided by the National Institutes of Health (5U01DK048489) through the National Institute of Diabetes and Digestive and Kidney Diseases, the National Center on Minority Health and Health Disparities, the National Institute of Child Health and Human Development, the Office of Women's Health, and the National Institute on Aging. In addition, the Indian Health Service, the Centers for Disease Control and Prevention, the American Diabetes Association, and 2 pharmaceutical companiesBristol-Myers Squibb and Parke-Daviscontributed support. The General Clinical Research Center Program, National Center for Research Resources, supported many of the clinical centers. Support to the clinical centers and the Coordinating Center was provided by the National Institute of Diabetes and Digestive and Kidney Diseases through a cooperative agreement, except for the Southwestern American Indian Centers, which were supported directly by the National Institute of Diabetes and Digestive and Kidney Diseases and the Indian Health Service. Potential Financial Conflicts of Interest: Consultancies: T.J. Orchard (Metabolic Syndrome Alliance, Sanofi-Aventis); Grants received: R. Ratner (Bristol-Myers Squibb). Requests for Single Reprints: Diabetes Prevention Program Coordinating Center, The Biostatistics Center, George Washington University, 6110 Executive Boulevard, Suite 750, Rockville, MD 20852. Current Author Addresses: Dr. Orchard: Diabetes and Lipid Research Building, University of Pittsburgh, 3512 5th Avenue 203, Pittsburgh, PA 15213. Ms. Temprosa and Dr. Fowler: George Washington Univers Continue reading >>
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Cultural Adaptation Of A Peer-led Lifestyle Intervention Program For Diabetes Prevention In India: The Kerala Diabetes Prevention Program (k-dpp)
Cultural adaptation of a peer-led lifestyle intervention program for diabetes prevention in India: the Kerala diabetes prevention program (K-DPP) Type 2 diabetes mellitus (T2DM) is now one of the leading causes of disease-related deaths globally. India has the worlds second largest number of individuals living with diabetes. Lifestyle change has been proven to be an effective means by which to reduce risk of T2DM and a number of real world diabetes prevention trials have been undertaken in high income countries. However, systematic efforts to adapt such interventions for T2DM prevention in low- and middle-income countries have been very limited to date. This research-to-action gap is now widely recognised as a major challenge to the prevention and control of diabetes. Reducing the gap is associated with reductions in morbidity and mortality and reduced health care costs. The aim of this article is to describe the adaptation, development and refinement of diabetes prevention programs from the USA, Finland and Australia to the State of Kerala, India. The Kerala Diabetes Prevention Program (K-DPP) was adapted to Kerala, India from evidence-based lifestyle interventions implemented in high income countries, namely, Finland, United States and Australia. The adaptation process was undertaken in five phases: 1) needs assessment; 2) formulation of program objectives; 3) program adaptation and development; 4) piloting of the program and its delivery; and 5) program refinement and active implementation. The resulting program, K-DPP, includes four key components: 1) a group-based peer support program for participants; 2) a peer-leader training and support program for lay people to lead the groups; 3) resource materials; and 4) strategies to stimulate broader community engagement. Continue reading >>
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Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin
Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin Diabetes Prevention Program Research Group Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups. The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin. Lifestyle changes and treatment with metformin both reduced Continue reading >>
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
Diabetes Prevention Program (dpp)
The Diabetes Prevention Program (DPP) was a major multicenter clinical research study aimed at discovering whether modest weight loss through dietary changes and increased physical activity or treatment with the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in study participants. At the beginning of the DPP, participants were all overweight and had blood glucose, also called blood sugar, levels higher than normal but not high enough for a diagnosis of diabetes - a condition called prediabetes. The DPP found that participants who lost a modest amount of weight through dietary changes and increased physical activity sharply reduced their chances of developing diabetes. Taking metformin also reduced risk, although less dramatically. The DPP resolved its research questions earlier than projected and, following the recommendation of an external monitoring board, the study was halted a year early. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine . In the DPP, participants from 27 clinical centers around the United States were randomly divided into different treatment groups. The first group, called the lifestyle intervention group, received intensive training in diet, physical activity, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, they aimed to lose 7 percent of their body weight and maintain that loss. The second group took 850 mg of metformin twice a day. The third group received placebo pills instead of metformin. The metformin and placebo groups also received information about diet and exercise but no intensive motivational counseling. A fourth group was treated with the drug troglitazone (Rezu Continue reading >>
Two-year Weight-loss Maintenance In Primary Care-based Diabetes Prevention Program Lifestyle Interventions
Two-year weight-loss maintenance in primary care-based Diabetes Prevention Program lifestyle interventions Nutrition & Diabetes volume 3, page e76 (2013) To investigate whether the effects on weight loss and cardiometabolic risk factor reduction of two technology-mediated lifestyle interventions for 15 months in a primary care-based translation trial sustained at 24 months (that is, 9 months after the end of intervention). This study analyzed data from an extended follow-up of participants in the original E-LITE (Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care)-randomized controlled trial, which demonstrated the effectiveness of two adapted Diabetes Prevention Program (DPP) lifestyle interventions compared with usual primary care. E-LITE randomized 241 overweight or obese participants with pre-diabetes and/or metabolic syndrome to receive usual care alone (n=81) or usual care plus a coach-led (n=79) or self-directed intervention (n=81). The interventions provided coach-led group behavioral weight-loss treatment or a take-home, self-directed DVD using the same 12-week curriculum, followed by 12 additional months of technology-mediated coach contact and self-monitoring support. Participants received no further intervention after month 15. A blinded assessor conducted 24-month visits by following the measurement protocols of the original trial. Measurements include weight and cardiometabolic risk factors (waist circumference, fasting plasma glucose, resting blood pressure, triglycerides, high- and low-density lipoprotein cholesterol, total cholesterol and triglyceride to high-density lipoprotein cholesterol ratio). At month 24, means.e. changes in body mass index (trial primary outcome) and weight (kg) from baseline were 1.90.3 Continue reading >>
Prevention Of Diabetes Through The Lifestyle Intervention: Lessons Learned From The Diabetes Prevention Program And Outcomes Study And Its Translation To Practice.
A number of strategies have been used to delay or prevent the development of type 2 diabetes mellitus (T2D) in high-risk adults. Among them were diet, exercise, medications and surgery. This report focuses on the nutritional lessons learned from implementation of the Intensive Lifestyle Intervention (ILI) in the DPP and its follow-up DPPOS that looked at weight loss through modification of diet and exercise. The Diabetes Prevention Program (DPP) is a large clinical trial, sponsored by the National Institutes of Health, designed to look at several strategies to prevent conversion to type 2 diabetes (T2D) by adults with prediabetes (IGT/IFG) including an Intensive Lifestyle Intervention (ILI). The 3800 ethnically diverse participants (46% reported non-white race) were overweight, had impaired glucose tolerance (IGT) and impaired fasting glucose (IFG). Treatments were assigned randomly. The Diabetes Prevention Program Outcomes Study (DPPOS) is a follow up study evaluating the long-term outcomes of the clinical trial. Continue reading >>
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Dpp-group Lifestyle Balance Publications
Kramer MK, Vanderwood, K, Arena, VC, Miller, RG, Meehan, R, Eaglehouse, YL, Schafer, G, Venditti, EM, Kriska, AM. Evaluation of a Diabetes Prevention Program Lifestyle Intervention in Older Adults: A Randomized Controlled Study in Three Senior/Community Centers of Varying Socioeconomic Status . The Diabetes Educator. 2018;44(2):118-129. Wardian, J, True, M, Sauerwein, T, Watson, N, Hoover, A. Evaluation of the Group Lifestyle Balance Program in a Military Setting: An Investment Worth Expanding. Military Medicine. 2018;183:e138-e143. Driver, S, Reynolds, M, Kramer, K. Modifying an evidence-based lifestyle programme for individuals with traumatic brain injury . Brain Injury. July, 2017, 1-5. PMID:28750178PMID:28750178DOI: 10.1080/02699052.2017.1346286 Eaglehouse YL, Schafer GL, Arena VC, Kramer MK, Miller RG, Kriska AM. Impact of a community-based lifestyle intervention program on health-related quality of life. Qual Life Res. 2016 Aug;25(8):1903-12. doi: 10.1007/s11136-016-1240-7. Epub 2016 Feb 20. PubMed PMID: 26896960. Rosas LG, Lv N, Xiao L, Lewis MA, Zavella P, Kramer MK, Luna V, Ma J. Evaluation of a culturally-adapted lifestyle intervention to treat elevated cardiometabolic risk of Latino adults in primary care (Vida Sana): A randomized controlled trial . Contemporary Clinical Trials. 2016 Mar 16;48:30-40. PMID:26995280. doi:10.1016/j.cct.2016.03.003. Eaglehouse YL, Rockette-Wagner B, Kramer MK, Arena VC,Miller RG, Vanderwood KK, Kriska AM. Physical activity levels in a community lifestyle intervention: a randomized trial. Translational Journal of the American College of Sports Medicine. 2016; 1(5): 45-51. Ma, J., Yank, V., Nan, Lv, Goldhaber-Fiebertc, J., Lewisd, Kramer, MK, Snowden, M., Rosas, LG., Xiaoa, L., Blonstein, A. Research Aimed at Improving both Mood a Continue reading >>
Evaluation Of Physical Activity Reporting In Community Diabetes Prevention Program Lifestyle Intervention Efforts: A Systematic Review - Sciencedirect
Evaluation of physical activity reporting in community Diabetes Prevention Program lifestyle intervention efforts: A systematic review Author links open overlay panel Yvonne L.Eaglehousea Physical activity is one of two key goals in DPP adapted lifestyle interventions. Physical activity assessment is reported in 82% of community translation efforts. Physical activity results are reported in 60% of community translation efforts. Inconsistent reporting complicates conclusions regarding program effectiveness. The Diabetes Prevention Program (DPP) lifestyle intervention has been translated to community settings using the DPP goals of 7% weight loss and 150min of moderate physical activity (PA) per week. Given that PA is a primary lifestyle goal and has been linked to improvements in metabolic health in the DPP, it is important to understand the role that PA plays in translation effort success. The purpose of this review is to thoroughly evaluate the reporting of PA methodology and results in DPP-based translations in order to guide future prevention efforts. PubMed and Ovid databases were searched to identify peer-reviewed original research articles on DPP-based translations for adults at-risk for developing diabetes or cardiovascular disease, limited to English language publications from January 2002March 2015. 72 original research articles describing 57 translation studies met eligibility criteria. All 57 study interventions included a PA goal, 47 studies (82%) collected participant PA information, and 34 (60%) provided PA results. Despite PA being a primary intervention goal, PA methodology and results are under-reported in published DPP translation studies. This absence and inconsistency in reporting PA needs addressed in order to fully understand translation efforts' Continue reading >>
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Baseline Obesity Status Modifies Effectiveness Of Adapted Diabetes Prevention Program Lifestyle Interventions For Weight Management In Primary Care
Baseline Obesity Status Modifies Effectiveness of Adapted Diabetes Prevention Program Lifestyle Interventions for Weight Management in Primary Care 1Palo Alto Medical Foundation Research Institute, 795 El Camino Real, Ames Building, Palo Alto, CA 94301, USA 2Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Received 30 September 2013; Accepted 13 November 2013 Copyright 2013 Kristen M. J. Azar et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To examine whether baseline obesity severity modifies the effects of two different, primary care-based, technology-enhanced lifestyle interventions among overweight or obese adults with prediabetes and/or metabolic syndrome. Patients and Methods. We compared mean differences in changes from baseline to 15 months in clinical measures of general and central obesity among participants randomized to usual care alone ( ) intervention, stratified by baseline body mass index (BMI) category. Results. Participants with baseline BMI had greater reductions in mean BMI, body weight (as percentage change), and waist circumference in the coach-led group intervention, compared to usual care and the self-directed individual intervention ( for all). In contrast, the self-directed intervention was more effective than usual care only among participants with baseline BMIs between . Mean weight loss exceeded 5% in the coach-led intervention regardless of baseline BMI category, but this was achieved only among self-directed intervention participants with baseline BMIs . Conclusions. Baseline BMI may infl Continue reading >>
- The cost-effectiveness of primary care for Indigenous Australians with diabetes living in remote Northern Territory communities
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- Mobile App-Based Interventions to Support Diabetes Self-Management: A Systematic Review of Randomized Controlled Trials to Identify Functions Associated with Glycemic Efficacy
Effect Of Lifestyle Intervention And Metformin On Preventing Or Delaying Diabetes Among Women With And Without Gestational Diabetes: The Diabetes Prevention Program Outcomes Study 10-year Follow-up | The Journal Of Clinical Endocrinology & Metabolism | Oxford Academic
Over 10 years, women with a history of GDM assigned to placebo had a 48% higher risk of developing diabetes compared with women without a history of GDM. In women with a history of GDM, ILS and metformin reduced progression to diabetes compared with placebo by 35% and 40%, respectively. Among women without a history of GDM, ILS reduced the progression to diabetes by 30%, and metformin did not reduce the progression to diabetes. Women with a history of GDM are at an increased risk of developing diabetes. In women with a history of GDM in the DPP/Diabetes Prevention Program Outcomes Study, both lifestyle and metformin were highly effective in reducing progression to diabetes during a 10-year follow-up period. Among women without a history of GDM, lifestyle but not metformin reduced progression to diabetes. A history of gestational diabetes (GDM) confers an increased risk of developing diabetes ( 1 3 ). Recognizing this increased risk, the Diabetes Prevention Program (DPP) sought to include women with a history of GDM and successfully enrolled 350 such participants. In the first 3-year intervention period of the DPP, the rate of progression to diabetes in women with a history of GDM in the placebo group was much higher than in women without a history of GDM (15.2 vs 8.9 cases per 100 person-years, respectively), despite equivalent fasting and 2-hour postglucose load glucose levels at baseline ( 2 ). Intensive lifestyle intervention (ILS) reduced the progression to diabetes in the DPP cohort as a whole by 58% and metformin reduced progression by 31%, compared with placebo ( 4 ). In women with a history of GDM, ILS reduced the incidence of diabetes by 53% and metformin reduced the incidence by 50%. In women without GDM, ILS had a similar impact on risk reduction (49%), wher Continue reading >>
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Adapting The Diabetes Prevention Program Lifestyle Intervention For Delivery In The Community: The Ymca Model
Adapting the Diabetes Prevention Program Lifestyle Intervention for Delivery in the Community: The YMCA Model Improving Diabetes Prevention and Management This January 2009 article from The Diabetes EDUCATOR, Adapting the Diabetes Prevention Program Lifestyle Intervention for Delivery in the Community: The YMCA Model describes the approach to adapting the Diabetes Prevention Program (DPP) for implementation at YMCA centers to increase community access to an effective diabetes reduction program through lifestyle changes. The YMCA used the same DPP training materials, but made modifications designed to lower costs while achieving the same results. Modifications included using YMCA staff instead of masters level educators, and group education sessions instead of individual sessions. They also reduced costly incentives. With these adaptations, the YMCA DPP program is estimated to cost $275 to $325 per participant, compared to more than $1400 per participant in the original DPP intervention. The article encourages further evaluation of the YMCA centers as a replicable model for sustainable, cost-effective, community-based diabetes reduction programs. Continue reading >>
Adapted Diabetes Prevention Program Lifestyle Intervention Can Be Effectively Delivered Through Telehealth
Adapted Diabetes Prevention Program Lifestyle Intervention Can Be Effectively Delivered through Telehealth The Diabetes Prevention Progr The Diabetes Prevention Program[apos]s (DPP) lifestyle intervention is an effective strategy to significantly reduce the risk for the development of Type 2 diabetes among persons at high-risk. In 2007 the Montana Department of Public Health and Human Services successfully implemented an adapted group-based DPP lifestyle program in 8 health care facilities across the state. Adults at high-risk for diabetes or CVD were recruited. Participants were eligible if they were overweight and had one or more of the following risk factors: pre-diabetes, IGT/IFG, a history of GDM or the delivery of an infant [gt]9 pounds, hypertension, or dyslipidemia. In 2009, we tested the feasibility of delivering the adapted lifestyle intervention through telehealth video conferencing. The intervention was delivered to an onsite group in one community and simultaneously through telehealth to a second group in a remote frontier community. Thirteen and 16 eligible adults enrolled in the onsite and the telehealth program and 13 and 14 completed the 16 week core program, respectively. The mean age of the telehealth and onsite groups were 50 and 53 and 93% and 69% of the telehealth and onsite group were female. The mean baseline BMI[apos]s for the onsite and the telehealth groups were 34.0 kg/m[sup]2[/sup] (SD 6.6) and 38.7 kg/m[sup]2[/sup] (SD 7.7), respectively(p=.10). There were no statistically significant differences in the attainment of physical activity and weight loss goals, and weight loss between the telehealth and the onsite groups (Table). Both groups experienced a significant reduction (P [underline][lt][/underline] 0.05) in mean weight upon completion Continue reading >>
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The Diabetes Prevention Program (dpp)
The purpose of the present article is to provide a detailed description of the highly successful lifestyle intervention administered to 1,079 participants, which included 45% racial and ethnic minorities and resulted in a 58% reduction in the incidence rate of diabetes (2). The two major goals of the Diabetes Prevention Program (DPP) lifestyle intervention were a minimum of 7% weight loss/weight maintenance and a minimum of 150 min of physical activity similar in intensity to brisk walking. Both goals were hypothesized to be feasible, safe, and effective based on previous clinical trials in other countries (3–7). The methods used to achieve these lifestyle goals include the following key features: 1) individual case managers or “lifestyle coaches;” 2) frequent contact with participants; 3) a structured, state-of-the-art, 16-session core-curriculum that taught behavioral self-management strategies for weight loss and physical activity; 4) supervised physical activity sessions; 5) a more flexible maintenance intervention, combining group and individual approaches, motivational campaigns, and “restarts;” 6) individualization through a “toolbox” of adherence strategies; 7) tailoring of materials and strategies to address ethnic diversity; and finally 8) an extensive network of training, feedback, and clinical support. RATIONALE FOR DPP LIFESTYLE INTERVENTION At the time the DPP was being designed, evidence from a number of observational studies and three intervention studies (3–5) suggested that lifestyle intervention might reduce the risk of developing diabetes. Although none of the three intervention studies was a randomized controlled trial, they all suggested that modest changes in lifestyle could lower the risk of diabetes. In the Malmo study (3), parti Continue reading >>
How Effective Were Lifestyle Interventions In Real-world Settings That Were Modeled On The Diabetes Prevention Program?
Health Affairs Vol. 31, No. 1 : Confronting The Growing Diabetes Crisis How Effective Were Lifestyle Interventions In Real-World Settings That Were Modeled On The Diabetes Prevention Program? Mohammed K. Ali ( [emailprotected] ) is an assistant professor of global health at the Rollins School of Public Health, Emory University, in Atlanta, Georgia. Justin B. Echouffo-Tcheugui is a postdoctoral research fellow at the Rollins School of Public Health, Emory University. David F. Williamson is a visiting professor at the Rollins School of Public Health, Emory University. PUBLISHED:January 2012Free Access We conducted a systematic review and meta-analysis of twenty-eight US-based studies applying the findings of the Diabetes Prevention Program, a clinical trial that tested the effects of a lifestyle intervention for people at high risk for diabetes, in real-world settings. The average weight change at twelve months after the intervention was a loss of about 4percent from participants baseline weight. Change in weight was similar regardless of whether the intervention was delivered by clinically trained professionals or lay educators. Additional analyses limited to seventeen studies with a nine-month or greater follow-up assessment showed similar weight change. With every additional lifestyle session attended, weight loss increased by 0.26percentage point. We conclude that costs associated with diabetes prevention can be lowered without sacrificing effectiveness, using nonmedical personnel and motivating higher attendance at program sessions. Diabetes causes disabling complications, high health costs, and reduced life expectancy. 1 , 2 In the United States, twenty-six million adults have the disease. A further seventy-nine million people have prediabetes, where elevated blood Continue reading >>
Healthy Body Healthy Souls: A Weight Loss Intervention Using Diabetes Prevention Program Lifestyle Intervention (dpp-li) With Church Level Systems Change In The Marshallese Population
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Healthy Body Healthy Souls: A Weight Loss Intervention Using Diabetes Prevention Program Lifestyle Intervention (DPP-LI) With Church Level Systems Change in the Marshallese Population The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT03377244 Recruitment Status : Not yet recruiting Information provided by (Responsible Party): Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information The study aim is to pilot test and compare the effectiveness of achieving weight loss between implementation of: 1) the Diabetes Prevention Program Lifestyle Intervention (DPP-LI) and 2) Healthy Bodies Healthy Souls (HBHS) intervention which includes the same DPP-LI with the additional enhancement of working with Marshallese churches to implement organizational/institutional level changes to support the individual behavioral intervention of the DPP-LI. Behavioral: Diabetes Prevention Program Lifestyle Intervention (DPP-LI) with Healthy Bodies Healthy Souls (HBHS) Healthy Body Healthy Souls: A Weight Loss Intervention Using Diabetes Prevention Program Lifestyle Intervention (DPP-LI) With Church Level Systems Change in the Marshallese Population Healthy Bodies, Healthy Souls intervention Participants in Diabetes Prevention Program Lifestyle Intervention (DPP-LI) with Healthy Bodies Health Continue reading >>
- Factors related to lifestyle goal achievement in a diabetes prevention program dissemination study
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- A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes
