Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Diabetes Community Lifestyle Improvement Program (D-CLIP): A Translation Randomized Trial of a Culturally Specific Lifestyle Intervention for Diabetes Prevention in India
Brief Summary: People from the Indian subcontinent are more likely to get diabetes, even at younger ages. The Diabetes Community Lifestyle Improvement Program (D-CLIP) will test in a randomized trial if a culturally specific, community-based lifestyle and metformin (for individuals who do not respond to lifestyle change alone) intervention for men and women living in Chennai, India can effectively prevent type 2 diabetes in high-risk individuals. Lifestyle interventions are programs that seek to prevent disease by promoting changes in health behaviors, improved diet, increased physical activity, and weight loss. The results of this program will be used to make policy and public health recommendations, which will result in broader diabetes prevention efforts. The research team hypothesizes that this program will result in improvements in health (diabetes prevention, weight loss, and improvements in other markers of chronic disease) for intervention participants compared to participants in the control arm of the study.


Options:
A: Inclusion Criteria:

* Women aged 18 or older having gestational diabetes, regardless of the diagnostic criteria, who used insulin during their pregnancy or were found to have impaired glucose tolerance or impaired fasting glucose (\>=100 mg/dL) on a post-partum oral glucose tolerance test (OGTT).
* We amended the protocol to also include women using oral hypoglycemics during pregnancy because their use increased during the trial implementation.

Exclusion Criteria:

* Confirmed postpartum diabetes (two abnormal OGTTs) or current use of antidiabetic medication
* Indication that the trial interventions will not be feasible, for example, distance from the trial site
* Poor attendance/response in previous contacts (appointments or phone interviews)
* Health limitations or treatments (assessed by questionnaire) restricting the nutritional intervention or the ability to practice physical activity, affecting glucose tolerance or limiting participation or survival.
B: Patients that will be included into the study if they have either / or

* Diagnosed with Pre-Diabetes (IGT or IFG)
* Aged 40 - 75 if English speaking European or 25 - 75 if South Asian
* Able to attend group education sessions

Exclusion Criteria:

Patients will be excluded from the study if they are:

* Unable to give consent
* Unable to attend group education sessions
* Diagnosis of diabetes at screening or during the study
* Require an interpreter for language other than South Asian
C: Inclusion Criteria:

* Live in or near Chennai, India
* Aged 20-65 years
* A BMI \>22 kg/m2 and/or a waist circumference \>90 cm for men and \>80 cm for women
* No prior diabetes diagnosis, except for gestational diabetes
* At high risk of developing diabetes (pre-diabetes) as defined by a casual capillary glucose greater than or equal to 110 (measured during screening) AND Baseline fasting glucose of 100-125 mg/dL and/or 2-hour post-load glucose of 140-199 mg/dL
* Willingness to consent to randomization

Exclusion Criteria:

* Does not fulfill inclusion criteria
* Currently pregnant or breastfeeding
* History of or biomarkers indicating heart disease, serious illness, cancer diagnosis in the past 5 years, or other conditions that may impede or prohibit participation in an unsupervised diet change and physical activity program.
D: Inclusion Criteria:

* caucasion,age 40-70, mean 2hr glucose 7.8-12.5 mmol/l, mean fasting blood glucose below 7.8

Exclusion Criteria:

* known type 2 diabetes, mean 2hr glucose \>12.5 mmol/l, mean fasting blood glucose \> 7.8 mmol/l, chronic illness that makes 5-year survival improbable, interferes with glucose tolerance or makes participation in a lifestyle intervention impossible, medication known to interfere with glucose tolerance, participation in a vigorous exercise and/or diet program

Answer: C