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Diabetes Prevention Program New England Journal Of Medicine 2002

Mainehealth Practice Awarded Grant To Focus On Diabetes Prevention

Mainehealth Practice Awarded Grant To Focus On Diabetes Prevention

MaineHealth Practice Awarded Grant to Focus on Diabetes Prevention MaineHealth Practice Awarded Grant to Focus on Diabetes Prevention The American College of Preventive Medicine has awarded a $15,000 grant to Maine Medical Partners Portland Family Medicine to develop new practice models that address type 2 diabetes. Funding will be used to develop and implement a new protocol for referring patients to the National Diabetes Prevention Program (NDPP), a CDC-recognized lifestyle change program. According to the CDC, more than one out of three adults in the U.S. have prediabetes. In Maine, over 457,000 people have prediabetes and are at risk for developing type 2 diabetes. Lifestyle change programs like NDPP can help prevent or delay the onset of type 2 diabetes. As a family physician, I am committed to supporting my patients in increasing physical activity and healthy eating, said Christina Holt, MD, director of the Preventive Medicine Residency Program at Maine Medical Center and a physician at Maine Medical Partners. Programs like NDPP are great for my patients with prediabetes who are looking to make some changes, and who want support and training thats been proven to work for people like them. NDPP is an evidence-based program based on research led by the National Institutes of Health. Researchers published their findings in the New England Journal of Medicine in 2002. The research showed that people with prediabetes who take part in a structured lifestyle change program cut their risk of developing type 2 diabetes by 58 percent through modest weight loss (5 percent to 7 percent of body weight). One of the practices referral strategies will involve connecting patients with health educators at the MaineHealth Learning Resource Center who will discuss the program and re Continue reading >>

The Diabetes Prevention Program (dpp)

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 >>

Metformin Use In Patients With Prediabetes

Metformin Use In Patients With Prediabetes

This article requires a subscription for full access. NEJM Journal Watch articles published within the last six months are available to subscribers only. Articles published more than 6 months ago are available to registered users. Continue reading >>

Knowler, W.c., Barrett-connor, E., Fowler, S.e., Et Al. (2002) Diabetes Prevention Program Research Group. Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin. New England Journal Of Medicine, 346, 393-403. - References - Scientific Research Publishing

Knowler, W.c., Barrett-connor, E., Fowler, S.e., Et Al. (2002) Diabetes Prevention Program Research Group. Reduction In The Incidence Of Type 2 Diabetes With Lifestyle Intervention Or Metformin. New England Journal Of Medicine, 346, 393-403. - References - Scientific Research Publishing

JOURNAL NAME: Open Journal of Therapy and Rehabilitation , Vol.4 No.3 , August 5, 2016 ABSTRACT: Existing literature indicates that a weight-management program that includes diet modification, Physical Activity (PA) instructions and behavioral modification in weight reduction increases obese adolescents participation in PA. However, the effect of such a program on obese Saudi adolescents is unknown. Objective: To examine the effects of a weight-management program in terms of decreasing Body Mass Index (BMI) and improving participation in PA in obese Saudi adolescents, and to establish whether differences exist between genders in response to a weight-management program. PA was measured by Arab Teens Life Style (ATLS) questionnaire for both groups. Results: A wide range of differences in PA and sedentary time are evident between new and weight- managed patients and two genders. PA performance was significantly higher among the weight- managed patients compared with new patients. Also, for boys there were no differences between both groups in PA performance. While, girls PA was significantly higher among the girls in weight- managed group compared with girls in new patients group. Weight-managed patients spend significantly less time on the computer and/or the Internet per day compared with new patients. After treatment, the mean BMI among the weight-managed patients slightly decreased. Conclusion: The study findings suggest that the weight-management program could be effective in treating Saudi obese adolescents due to its effect in BMI reduction and greater improvement in PA performance. The surprising result from this study, PA differences between the groups were because of the total PA of girls only, meaning that obesity treatment program can lower the percentage of o Continue reading >>

Diabetes Prevention School Of Medicine University Of Louisville

Diabetes Prevention School Of Medicine University Of Louisville

Watch for patients who meet pre-diabetes criteria of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT): Fasting blood sugars in the range of 100 to 126 (IFG) 2-hour OGTT with blood sugars in the range of 140 to 199 (IGT) Suggest lifestyle intervention for patients with IFG or IGT. Losing 7% of body weight and being active about 150 minutes per week were key factors in the success of the DPP study. Other interesting findings include: The DPP found that reinforcement and follow-up are very important for the long-term success in achieving lifestyle modification. Therefore, regardless of whether you facilitate the weight loss and/or activity or you refer, lifestyle change reminders by the PCP at each office visit are very important! 1 The chances of developing type 2 diabetes increase by 14% for every 2 hours spent watching television vs. pursuing activity. Choosing whole grains and whole grain products over highly processed carbohydrates help to prevent type 2 diabetes. Smokers are 50 to 90% more likely to develop type 2 diabetes than non-smokers. For more information on diabetes, try the following resources: American Diabetes Association Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine. 2002;346:393-403. Hu FB, Manson JE, Stampfer MJ, Colditz G, Liu S, Solomon CG, et al. Diet, lifestyle, and the risk of type 2 diabetes mellitus in women. New England Journal of Medicine. 2001;345:790-7. van Dam RM, Rimm EB, Willet WC, Stampfer MJ, Hu FB. Dietary patterns and risk for type 2 diabetes mellitus in men. Annals of Internal Medicine. 2002;136:201-9. Hu FB, Sigal RJ, Rich-Edwards JW, Colditz GA, Solomon CG, Willet WC, et al. Walking compared with vi Continue reading >>

Eal

Eal

A - Click here for explanation of classification scheme. To determine if a lifestyle intervention or treatment with metformin, a biguanide antihyperglycemic agent, prevents the delay or onset of diabetes. Also, to see if the effectiveness differs between a lifestyle intervention or treatment with metformin and if these two interventionseffectiveness differs according to age, sex, or race. Nondiabetic persons with elevated fasting and post-load plasma glucose concentrations Plasma glucose concentration of 95 - 125 mg/dl in fasting state and 140 - 199 mg/dl 2 hours after a 75-g oral glucose load Taking medications known to alter glucose metabolism Had illnesses that could seriously reduce life expectancy or their ability to participate in the trial Recruitment was designed to enroll approximately half the participants from racial or ethnic minority groups. A 4-step screening and recruitment process was developed to identify eligible participants. Blinding used (if applicable): not possible; assignment tometformin and placebo were double-blinded. Randomly assigned to placebo, metformin (850 mg twice daily) or lifestyle modification program (16 lesson curriculum covering diet, exercise and behavior modification) with goals of at least 7% weight loss and at least 150 minutes of physical activity per week Study design and treatment followed intention-to-treat principle. Study design provided 90% power to detect a 33% reduction from an incidence of 6.5 cases of diabetes per 100 person years, with a 10% rate of loss to follow-up per year. The time to the outcome was assessed using life-table methods. Modified product-limit curves for the cumulative incidence of diabetes were compared with the use of the log-rank test. The estimated cumulative incidence at 3 years and the Green Continue reading >>

Dpp: Lifestyle, Metformin Prevents Type 2 Dia...

Dpp: Lifestyle, Metformin Prevents Type 2 Dia...

Diabetes Prevention Program: Lifestyle change, metformin treatment prevent progression to type 2 diabetes Boston, MA - Long-awaited final results of the Diabetes Prevention Program (DPP) show a dramatic 58% reduction in new type 2 diabetes with an intensive lifestyle intervention focused on weight loss, and a 31% reduction with metformin (Glucophage - Bristol-Myers Squibb) treatment, among subjects at high risk for developing the disease. The report, from the Diabetes Prevention Program Research Group, is published in the February 7, 2002 issue of the New England Journal of Medicine[ 1 ]. The group's findings suggest these strategies represent two "highly effective" means of preventing type 2 diabetes, the researchers write. They estimate about 10 million Americans resemble DPP participants in terms of their age, BMI, and glucose concentrations. "If the study's interventions were implemented among these people, there would be a substantial reduction in the incidence of diabetes," they write. Reimbursement for lifestyle interventions? "The lifestyle intervention was particularly effective, with one case of diabetes prevented per seven persons treated for 3 years," the authors, led by Dr William Knowler (National Institute of Diabetes and Digestive and Kidney Diseases), write. (In order to prevent one case of diabetes, 13.9 patients would have to receive metformin for 3 years.) "Thus, it should also be possible to delay or prevent the development of complications, substantially reducing the individual and public health burden of the disease," Knowler et al conclude. The success of the lifestyle modification arm in this trial raises again the thorny issue of who pays for preventive intervention. "I would certainly recommend that people who are at high risk for type 2 diab Continue reading >>

Diabetes Prevention Program Outcomes Study

Diabetes Prevention Program Outcomes Study

The Biostatistics Center serves as the Coordinating Center for the Diabetes Prevention Program Outcomes Study (DPPOS), a multi-center clinical trial of the primary prevention of diabetes. The Diabetes Prevention Program (DPP) was a partially double-masked, placebo- controlled, randomized clinical trial designed to evaluate the safety and efficacy of intensive lifestyle intervention (7% loss of body weight and an increase in calorie expenditure of at least 700 kcal per week) and pharmacological intervention (the biguanide metformin) on the prevention of diabetes in participants with impaired glucose tolerance (IGT). Over a three-year period in 27 U.S. clinical sites, DPP enrolled 3,234 participants with IGT. Participants were randomized to one of three treatment groups: placebo, metformin, or intensive lifestyle intervention. Randomized participants were followed for two to five years with quarterly visits. The study found that the lifestyle intervention reduced the risk of developing diabetes by 58% over a 3-year period (New England Journal of Medicine, February 2002). The corresponding risk reduction for metformin was 31%. The DPP Research Group was funded to conduct continued follow-up of the DPP cohort for an additional eleven years to evaluate the effects of the interventions on further development of diabetes and diabetes complications, including retinopathy, microangiopathy, and cardiovascular disease. Funding by NIH/ National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (U01-DK-048489), 1994-2013; IND 49,782.) Continue reading >>

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

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 the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin. Continue reading >>

Stop Diabetes Before It Starts

Stop Diabetes Before It Starts

VIDEO: Watch Chef Daniel Thomas prepare nutritious foods that are healthy for people with pre-diabetes, including delicious ways to add more beans to your diet. What is prediabetes? Let’s start with what prediabetes is not. It’s not a disease, and it has no obvious symptoms. So why should you care? Because prediabetes indicates high blood sugar, just not high enough to be type 2 diabetes — yet. It’s an indication that you’re on the path to diabetes unless you alter your eating and fitness habits. The important message: You can probably fix the problem if you take the right steps. Who is at risk? The biggest risk factors are obesity and a sedentary lifestyle, says Gregg Simonson, director of professional training and consulting at the International Diabetes Center in St. Louis Park, Minn. Genetics is important as well: Even lean folks who have a strong family history of diabetes can get prediabetes. The American Diabetes Association offers a test that assesses your risk. Why does prediabetes risk increase around age 45? The cells of your body require insulin to absorb glucose, which they need in order to function. If you’re younger and you suffer from insulin resistance (a condition in which your cells have a harder time absorbing glucose), your more vigorous pancreas can usually compensate for the problem by manufacturing more insulin. But your pancreas becomes less effective with age, explains dietitian Hillary Wright, director for nutrition counseling for the Domar Center for Mind/Body Health in Waltham, Mass. That could cause more glucose to accumulate in the bloodstream. What are the obvious symptoms of prediabetes? There aren’t any. And even though roughly 1 in 3 American adults have prediabetes, 90 percent of those people don’t know it, according t Continue reading >>

An Overview Of The Diabetes Prevention Program (dpp)

An Overview Of The Diabetes Prevention Program (dpp)

An overview of the 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 diabetesa 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 gr Continue reading >>

Dpp - Wiki Journal Club

Dpp - Wiki Journal Club

In patients at high risk of developing type 2 diabetes, do intensive lifestyle changes or metformin treatment prevent or delay the onset of diabetes? In patients at high risk of developing type 2 diabetes, intensive lifestyle changes and metformin treatment both reduced the incidence of diabetes. Obesity, sedentary lifestyle, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) are risk factors for type 2 diabetes (T2DM). The Diabetes Prevention Program (DPP) randomized 3,234 patients at high risk of T2DM (increased BMI, elevated fasting plasma glucose (5.3-6.9 mmol/L) and IGT (7.8-11.0 mmol/L) to receive standard lifestyle modification and placebo, standard lifestyle modification and metformin, or an intensive lifestyle intervention program. The 2.8 year follow-up results show that intensive lifestyle intervention and metformin reduced the incidence of T2DM by 58% (95% CI 48-66%) and 31% (95% CI 17-43%) respectively, as compared to placebo. In both groups, there was a significant (P<0.001) decrease in fasting plasma glucose and HbA1c as compared to placebo (P<0.001) . Intensive lifestyle intervention was associated with an average weight loss of 5.6 kg (0.1 kg in placebo; P<0.001) whereas in the metformin group there was an average weight loss of 2.1 kg (0.1 kg in placebo; P<0.001). Additionally, both interventions led to reduced total caloric and fat intake (P<0.001). Patients who received metformin group had a high rate of gastrointestinal symptoms as compared to placebo (77.8% vs. 30.7% events/100 person-yr; P<0.01). Overall, hospitalization and mortality rates were similar across all 3 groups. Additionally, within-trial cost-effectiveness analysis concluded that the lifestyle and metformin interventions were cost-effective. [1] The DPP study was in Continue reading >>

Diabetes - Medicine Bibliographies - In Harvard Style

Diabetes - Medicine Bibliographies - In Harvard Style

Not logged in. Log in or create an account These are the sources and citations used to research Diabetes. This bibliography was generated on Cite This For Me on Your Bibliography: Mayo Clinic. (2014). Diabetes - Mayo Clinic. [online] Available at: [Accessed 13 Jan. 2017]. Diabetes Prevention Program Research Group Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin In-text: (Diabetes Prevention Program Research Group, 2002) Your Bibliography: Diabetes Prevention Program Research Group (2002). Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. New England Journal of Medicine, [online] 346(6), pp.393-403. Available at: [Accessed 13 Jan. 2017]. Diabetes Prevention Program Research Group 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study In-text: (Diabetes Prevention Program Research Group, 2009) Your Bibliography: Diabetes Prevention Program Research Group (2009). 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet, 374(9702), pp.1677-1686. Continue reading >>

Providers And Payers Pushed To Pay For Prevention In Diabetes Fight

Providers And Payers Pushed To Pay For Prevention In Diabetes Fight

While recent studies suggest that the rates of diabetes and obesity in the U.S. have finally plateaued, experts say reversing the twin epidemics will require widespread adoption of lifestyle intervention techniques that have been proven to reverse obesity, the cause of most Type 2 diabetes. Yet bipartisan legislation that would invest heavily in the diabetes prevention program languishes in Congress with zero chance of passage, according to the website www.govtrack.us . An analysis of the bill said its $7.7 billion in spending would be more than offset by the estimated $9.1 billion in savings from having fewer diabetic Medicare beneficiaries over the next 10 years, according to an analysis by Avalere Health (PDF) . The study, commissioned by the American Medical Association, the American Diabetes Association and the YMCA of the USA, said the savings would likely continue beyond the next decade, suggesting even greater impact on longer-term federal spending. We can't treat our way out of the diabetes epidemic, and we can't treat our way out of the obesity epidemic, said Loel Solomon, vice president of community health for Kaiser Permanente in Oakland, Calif., and a co-author of a new Health Affairs report on diabetes incidence. Everything we know about public health and everything our doctors know about the conditions their patients live in compels us to solve the problem upstream. About 1 in 8 Americans has diabetes while 1 in 3 is prediabetic, with a blood-sugar level of 5.7 to 6.4 (with 6.5 considered diabetic). Only about 11% of prediabetics are aware of their status, according to a Centers for Disease Control and Prevention report . A proven method for preventing obesity-related prediabetes from turning into diabetes has been known for more than a decade. Positive Continue reading >>

Diabetes Prevention Program (dpp)

Diabetes Prevention Program (dpp)

Please click here to go to the Diabetes Prevention Program Study Documents website. The Diabetes Prevention Program (DPP) was a major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug Metformin (Glucophage) could prevent or delay the onset of type 2 diabetes in people with Impaired Glucose Tolerance (IGT). The answer is yes, they both can. In fact, the DPP Study found that over 3 years, beneficial changes in diet and physical activity greatly reduced the chances that a person with IGT would develop diabetes. Metformin also reduced risk, although less dramatically. The DPP resolved these questions so quickly that, on the advice of an external monitoring board, the program was halted a year early. The researchers published their findings in the February 7, 2002, issue of the New England Journal of Medicine. DPP Study Design and Goals In the DPP, participants from 27 clinical centers around the country were randomly split into different treatment groups. The first group, called the lifestyle intervention group, received intensive training in diet, exercise, and behavior modification. By eating less fat and fewer calories and exercising for a total of 150 minutes a week, participants aimed to lose 7% 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 on diet and exercise, but no intensive counseling efforts. A fourth group was treated with the drug Troglitazone (Rezulin). This part of the study was discontinued after researchers discovered that Troglitazone can cause serious liver damage. All 3,234 study participants were overweight and had IGT Continue reading >>

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