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Diabetes Prevention Program Study

The Diabetes Prevention Program (dpp)

The Diabetes Prevention Program (dpp)

Go to: Abstract 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. Abbreviations: DPP, Diabetes Prevention Program; IGT, impaired glucose tolerance The Diabetes Prevention Program (DPP) was a 27-center randomized clinical trial to determine whether lifestyle intervention or pharmacological therapy (metformin) would prevent or delay the onset of diabetes in individuals with impaired glucose tolerance (IGT) who are at high risk for the disease (1). Recently, it was reported that both the lifestyle Continue reading >>

The Sydney Diabetes Prevention Program: A Community-based Translational Study

The Sydney Diabetes Prevention Program: A Community-based Translational Study

The Sydney Diabetes Prevention Program: A community-based translational study Colagiuri et al; licensee BioMed Central Ltd.2010 Type 2 diabetes is a major public health problem in Australia with prevalence increasing in parallel with increasing obesity. Prevention is an essential component of strategies to reduce the diabetes burden. There is strong and consistent evidence from randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet, increases physical activity and achieves weight loss in at risk people. The current challenge is to translate this evidence into routine community settings, determine feasible and effective ways of delivering the intervention and providing on-going support to sustain successful behavioural changes. The Sydney Diabetes Prevention Program (SDPP) is a translational study which will be conducted in 1,550 participants aged 50-65 years (including 100 indigenous people aged 18 years and older) at high risk of future development of diabetes. Participants will be identified through a screening and recruitment program delivered through primary care and will be offered a community-based lifestyle modification intervention. The intervention comprises an initial individual session and three group sessions based on behaviour change principles and focuses on five goals: 5% weight loss, 210 min/week physical activity (aerobic and strength training exercise), limit dietary fat and saturated fat to less than 30% and 10% of energy intake respectively, and at least 15 g/1000 kcal dietary fibre. This is followed by 3-monthly contact with participants to review progress and offer ongoing lifestyle advice for 12 months. The effectiveness and costs of the program on diabetes-related risk fac Continue reading >>

Preventt2: A Diabetes Prevention Program

Preventt2: A Diabetes Prevention Program

Risk Test Hedgehogs :60 | Type 2 Diabetes Prevention | Ad Council Take one minute and view the video above to see if you might have prediabetes. If you score 5 or more on the video quiz, or your doctor has already told you that you are at risk for type 2 diabetes, take another minute to register for an upcoming information session to find out how PreventT2 can help you. Reverse prediabetes through nutrition, physical activity and weight loss. Learn how to better manage the habits, triggers, stressors and social occasions that often get in the way of making healthy choices. Achieve and maintain a moderate amount of weight loss. Develop healthy habits that last a lifetime. Attend a FREE orientation to learn more about PreventT2. If you decide to join the program, you can enroll at the end of the orientation session. Gain a better understanding of this year-long experience. Select time and location preferences. Offerings vary throughout the year. Fill out enrollment forms if you decide to join. Thursday, March 22, 2018, 10-11 a.m., at Dominos Farms, Lobby C, 24 Frank Lloyd Wright Dr., Ann Arbor RSVP is required and space is filling up fast! Contact [email protected] or call 734-998-2475 (select option 1) to reserve your space today. The program is offered without charge to Blue Care Network, UM-Premier Care members. For all other insurance plans, fees may apply. Contact your insurance provider and/or your flexible health spending program to ask if some or all of the cost can be reimbursed to you. Coverage varies by plan. While many people know that type 2 diabetes is a serious health concern, far fewer people know about prediabetes. Prediabetes is a serious but reversible condition that affects 84 million American adults, or 1 in 3 people. That could be your broth 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 >>

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 >>

Lessons From Launching The Diabetes Prevention Program In A Large Integrated Health Care Delivery System: A Case Study

Lessons From Launching The Diabetes Prevention Program In A Large Integrated Health Care Delivery System: A Case Study

Population Health Management Vol. 20, No. 4 Original ArticlesOpen AccessOpen Access license Lessons from Launching the Diabetes Prevention Program in a Large Integrated Health Care Delivery System: A Case Study Office of Community & Population Health, Montefiore Health System, Bronx, New York. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York. Office of Community & Population Health, Montefiore Health System, Bronx, New York. Department of Family & Social Medicine, Albert Einstein College of Medicine, Bronx, New York. There is urgent need for health systems to prevent diabetes. To date, few health systems have implemented the evidence-based Diabetes Prevention Program (DPP), and the few that have mostly partnered with community-based organizations to implement the program. Given the recent decision by the Centers for Medicare & Medicaid Services to reimburse for diabetes prevention, there is likely much interest in how such programs can be implemented within large health systems or how community partnerships can be expanded to support DPP implementation. Beginning in 2010, Montefiore Health System (MHS), a large health care system in the Bronx, NY, partnered with the Young Men's Christian Association (YMCA) of Greater New York to deliver the YMCA's DPP. Over 4 years, 1390 referrals to YMCA's DPP were made; 287 participants attended 3 classes, and average weight loss was 3.4%. Because of increased patient demand and internal capacity, MHS assumed responsibility for DPP implementation in May 2015. Fully integrating the program within the health system took 56 months, including configuring electronic health record templates/reports, hiring a coordinator, and creating clinical referral workflows/training guides. Billing Continue reading >>

Diabetes Prevention Program Outcomes Study (dppos)

Diabetes Prevention Program Outcomes Study (dppos)

Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information The Diabetes Prevention Program (DPP) was a multi-center trial examining the ability of an intensive lifestyle or metformin to prevent or delay the development of diabetes in a high risk population due to the presence of impaired glucose tolerance (IGT). The DPP has ended early demonstrating that lifestyle reduced diabetes onset by 58% and metformin reduced diabetes onset by 31%. DPPOS (2002-2013) is designed to take advantage of the scientifically and clinically valuable DPP participants. This group of participants is nearly 50% minority and represents the largest IFG/IGT population ever studied. Clinically important research questions remain that focus on 1) durability of the prior DPP intervention, 2) determination of the clinical course of precisely known new onset diabetes, in particular regarding microvascular disease, CVD risk factors and atherosclerosis, 3) close examination of these topics in men vs women and in minority populations. The major aims of DPPOS-3 (2014-2025) take advantage of the long-term randomized exposure of the study cohort to metformin and the aging of the DPPOS cohort. The metformin exposure and high degree of study retention and adherence (~85% of the DPPOS cohort continues to attend annual and mid-year visits) allows DPPOS-3 to examine the long-term effects of metformin on cardiovascular disease (CVD) and cancer outcomes, outcomes of great clinical interest and import. Diabetes Prevention Program Outcomes Study randomized to unmasked Intensive Lifestyle during the DPP and offered Intensive Lifestyle Group Session, DPPOS Group Lifestyle plus DPPOS Boost Lifestyle sessions in DPPOS Phase 1 and 2 In addition to Continue reading >>

The Quiet Research That Led To A Resounding Success In Diabetes Prevention

The Quiet Research That Led To A Resounding Success In Diabetes Prevention

The Upshot |The Quiet Research That Led to a Resounding Success in Diabetes Prevention A scene from a diabetes prevention program at the Bronx Y.M.C.A. on Castle Hill Avenue. Lourdes Ventura, the lifestyle coach there, weighs the participants at the end of each class. Credit Benjamin Norman for The New York Times More than 86 million people , including 22 million people 65 or older, have pre-diabetes, which increases their risk of heart disease, strokes or diabetes. As weve watched that number grow, it has somehow felt that despite billions of dollars of research and intervention, theres little we can do. That feeling shifted last week when Sylvia Mathews Burwell, the secretary of health and human services, announced that Medicare was planning to pay for lifestyle interventions focusing on diet and physical activity to prevent Type 2 diabetes. Its an example of small-scale research efforts into health services that have worked and that have expanded to reach more people. Articles appear every day on major breakthroughs, which later never pan out, while this one, full of successes, rarely made the news. This is the curse of health services research , which seeks to improve population health through improvements in access or delivery of care. When most people think of diabetes research, theyre thinking about a cure or a new medication. Those grand slams are exciting, but they rarely happen. Nevertheless, people want to see them. Donors want to support them. Organizations hire people to go after them. Health services research is more about hitting singles, day after day. Theres no billion dollar payoff, no fame, no Nobel Prize. But it gets the job done, and its often more likely to change the health of most Americans. This announcement is based on work at an Indianapolis 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 >>

Effect Of Long-term Metformin And Lifestyle In The Diabetes Prevention Program And Its Outcome Study On Coronary Artery Calcium

Effect Of Long-term Metformin And Lifestyle In The Diabetes Prevention Program And Its Outcome Study On Coronary Artery Calcium

Abstract Background—Despite the reduced incidence of coronary heart disease (CHD) with intensive risk factor management, people with diabetes and prediabetes remain at increased CHD risk. Diabetes prevention interventions may be needed to reduce CHD risk. This approach was examined in the Diabetes Prevention Program (DPP) and its Outcome Study (DPPOS), a long-term intervention study in 3234 subjects with prediabetes (mean [±SD] age 64±10 yrs) which showed reduced diabetes risk with lifestyle and metformin compared to placebo over 3.2 years. Methods—The DPPOS offered periodic group lifestyle sessions to all participants and continued metformin in the originally randomized metformin group. Subclinical atherosclerosis was assessed in 2029 participants using coronary artery calcium (CAC) measurements after 14 years of average followup. The CAC scores were analyzed continuously as CAC severity, and categorically as CAC presence (CAC score>0), and reported separately in men and women. Results—There were no CAC differences between lifestyle and placebo intervention groups, in either sex. CAC severity and presence were significantly lower among men in the metformin versus the placebo group (age-adjusted mean CAC severity: 39.5 vs 66.9 AU, p=0.04; CAC presence: 75% vs 84%, p=0.02), but no metformin effect was seen in women. In multivariate analysis, the metformin effect in men was not influenced by demographic, anthropometric or metabolic factors, by the development of diabetes, or by use/non-use of statin therapy. Conclusions—Metformin may protect against coronary atherosclerosis in prediabetes and early diabetes among men. Clinical Trial Registration—URL: Unique Identifier: NCT00038727 Diabetes Prevention Program Outcomes Study (DPPOS) Continue reading >>

Metformin For Diabetes Prevention: Insights Gained From The Diabetes Prevention Program/diabetes Prevention Program Outcomes Study

Metformin For Diabetes Prevention: Insights Gained From The Diabetes Prevention Program/diabetes Prevention Program Outcomes Study

Abstract The largest and longest clinical trial of metformin for the prevention of diabetes is the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study (DPP/DPPOS). In this review, we summarise data from the DPP/DPPOS, focusing on metformin for diabetes prevention, as well as its long-term glycaemic and cardiometabolic effects and safety in people at high-risk of developing diabetes. The DPP (1996–2001) was a RCT of 3234 adults who, at baseline, were at high-risk of developing diabetes. Participants were assigned to masked placebo (n = 1082) or metformin (n = 1073) 850 mg twice daily, or intensive lifestyle intervention (n = 1079). The masked metformin/placebo intervention phase ended approximately 1 year ahead of schedule because of demonstrated efficacy. Primary outcome was reported at 2.8 years. At the end of the DPP, all participants were offered lifestyle education and 88% (n = 2776) of the surviving DPP cohort continued follow-up in the DPPOS. Participants originally assigned to metformin continued to receive metformin, unmasked. The DPP/DPPOS cohort has now been followed for over 15 years with prospective assessment of glycaemic, cardiometabolic, health economic and safety outcomes. After an average follow-up of 2.8 years, metformin reduced the incidence of diabetes by 31% compared with placebo, with a greater effect in those who were more obese, had a higher fasting glucose or a history of gestational diabetes. The DPPOS addressed the longer-term effects of metformin, showing a risk reduction of 18% over 10 and 15 years post-randomisation. Metformin treatment for diabetes prevention was estimated to be cost-saving. At 15 years, lack of progression to diabetes was associated with a 28% lower risk of microvascular complications across treatment Continue reading >>

Evaluation Of The Ymca Diabetes Prevention Program

Evaluation Of The Ymca Diabetes Prevention Program

Evaluation of the YMCA Diabetes Prevention Program Evaluation of the YMCA Diabetes Prevention Program Study connects a lifestyle intervention with health care savings Center for Medicare and Medicaid Innovation (Innovation Center) Type 2 diabetes widely afflicts the U.S. adult population, with more than one-third of adults at risk. In addition to the impact on patients and families, diabetes imposes a substantial burden on Medicare. According to the Centers for Medicare & Medicaid Services (CMS), one in four Medicare patients has diabetes, and treating diabetes consumes one-third of Medicare spending. More than 30 years of research shows that improving diet, exercising more, and losing weight can reduce the prevalence and incidence of Type 2 diabetes. But until now, few studies tied such lifestyle interventions to health care savings. In 2012 CMS provided an $11.8 million award to the YMCA to test whether a specific education program could reduce diabetes prevalence and incidence and reduce the cost of care. The award allowed the YMCA to implement the Centers for Disease Control and Preventions National Diabetes Prevention Program (DPP) at more than 250 locations in 11 states. An Educational Diet and Exercise Program Designed to Help Patients Lower the Risk of Becoming Diabetic Individuals with pre-diabetes aged 65 and over were invited to participate in the YMCA program, which was intended to help participants lose 5 percent of their total body weight and to gradually increase their physical activity to 150 minutes per week. Prediabetics have blood sugar levels that are higher than normal, making them at higher risk for developing diabetes. The CDC reports that losing 5 to 7 percent of body weight reduces the risk that prediabetes will progress to diabetes by 58 perce Continue reading >>

Scripps Diabetes Prevention Program

Scripps Diabetes Prevention Program

The Scripps Diabetes Prevention Program is part of the National Diabetes Prevention Program, led by the Centers for Disease Control and Prevention (CDC). It is proven to help people with prediabetes prevent or delay development of Type 2 diabetes. The Scripps Diabetes Prevention Program is free and can help people with prediabetes cut their risk of developing Type 2 diabetes in half. The Diabetes Prevention Program research study showed that making modest behavior changes helped participants lose 5 to 7 percent of their body weight — that is 10 to 14 pounds for a person weighing 200 pounds. These lifestyle changes reduced the risk of developing type 2 diabetes by 58 percent in people with prediabetes. Learn who is most at risk for developing prediabetes and Type 2 diabetes. CDC-approved curriculum Group support Year-long program — weekly for 4 months, then monthly for 8 months — to keep our health on track Can I prevent Type 2 diabetes? If you’ve heard your doctor say, “You’re at risk for Type 2 diabetes” or “You have prediabetes,” it means that you can start preventing Type 2 diabetes today. And you do not have to do it alone. If you have prediabetes, now is the time for prevention. As part of the Scripps Diabetes Prevention Program group, you will work with other participants and a trained lifestyle coach to learn the skills you need to make lasting changes. These changes include losing a modest amount of weight, being more physically active and managing stress. Being part of a group provides support from other people who are facing similar challenges and trying to make the same changes you are. Together you can celebrate successes and find ways to overcome obstacles. The Scripps Diabetes Prevention Program groups meet for a year — weekly for the f Continue reading >>

Diabetes Prevention Program Outcomes Study (dppos) Highlights

Diabetes Prevention Program Outcomes Study (dppos) Highlights

74th Scientific Sessions of the American Diabetes Association (ADA): Diabetes Prevention Program Outcomes Study (DPPOS) Highlights EndocrineWeb.com summarizes some of the results of the Diabetes Prevention Program Outcomes Study (DPPOS) featured during the American Diabetes Associations 74th Scientific Sessions held at the Moscone Center June 13-17, 2014 in San Francisco. The DPPOS data is timely, as the Centers for Disease Control and Prevention (CDC) just revealed that 29 million people in the United States (US) have diabetes. Approximately, 28 million of those individuals have Type 2 Diabetes (T2D). The incidence of new T2D cases per annum amounts to 1.7 million. Furthermore, the CDCs report indicates that 86 million people in the US are prediabetic and at increased risk for developing T2D over time. The Diabetes Prevention Program was a multicenter trial with 27 centers in the US. The DPP was designed to determine whether the development of diabetes could be prevented or delayed in persons of high-risk and very high risk, stated David M. Nathan, MD, Chairman of the DPP/DPPOS and Professor of Medicine at Harvard Medical School in Boston. At baseline, each volunteers glucose levels were elevated (prediabetes), and they all were overweight or obese. The study population represented racial, ethnic and age groups often affected by T2D. Lifestyle intervention group: behavioral modification aimed at reducing weight by 7%. Active treatment group: metformin was used to prevent diabetes, not treat it. The DPPOS, in follow-up to the DPP, was designed to determine if the development of diabetes demonstrated in the DPP studywhich was delayed over a brief time period would continue to be delayed or prevented over a longer time period, as well as the health and economic implicati Continue reading >>

Healthcare Organizations Partner To Study Effectiveness Of Virtual Diabetes Prevention Program

Healthcare Organizations Partner To Study Effectiveness Of Virtual Diabetes Prevention Program

Researchers from the University of Nebraska Medical Center and Wake Forest University are collaborating with San Francisco-based Omada Health to explore the effectiveness of a virtual diabetes prevention program. The PREDICTS (Preventing Diabetes with Digital Health and Coaching for Translation and Scalability) randomized control trial will include approximately 500 participants with verified clinical eligibility for Omadas CDC-recognized diabetes prevention program, according to an announcement. Omada Health is best known for its digitally-enabled intensive behavioral counseling, enabling individuals at elevated risk of chronic conditions like type 2 diabetes and heart disease to change the habits that put them most at risk, the organizations officials attest. Participants will be recruited at UNMC, then randomly assigned to either the Omada program or UNMCs current clinical practice. During the trial, UNMC will lead data collection and study the implementation process, while researchers at Wake Forest will be responsible for data system management, quality operational reports, evaluation, and analysis. Omada will run the experimental arm of the trial and provide engagement and outcome data for analysis. In addition to tracking weight loss and reduction in A1c blood sugar levels, the PREDICTS trial also will track the impact of the Omada program on participants quality of life, stress levels, and healthcare utilization, among other measures. This will be the first time many of these measures are tracked in a randomized controlled trial of a digitally-delivered diabetes prevention program, officials noted. Our goal at Omada has been to continually set new standards for what the industry should expect when it comes to the effectiveness of digital healthcare intervention Continue reading >>

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