Please select the eligibility criteria that correspond to the clinical trial below.
Title: Walking Away From Type 2 Diabetes: a Cluster Randomized Controlled Trial to Investigate the Effect of Structured Education on Walking Activity in Those With a High Risk of Developing Type 2 Diabetes
Brief Summary: Diabetes is a debilitating chronic disease reaching epidemic proportions. Lack of physical activity is a key factor driving this epidemic and it is therefore vital that workable methods of encouraging people to exercise and reducing inactivity are developed and tested if we are to stem the rising tide of diabetes.

This cluster randomised controlled trial will investigate whether a person-centred group educational programme can increase walking activity and reduce the risk of developing diabetes in high-risk individuals identified in primary care settings. In total 804 patients will be recruited to the study. Physical activity levels, glucose control, incidence of type 2 diabetes and anthropometric measurements (e.g. weight) will be tested on an annual basis over three years.

This trial will be the first to test the feasibility, efficacy and value for money of a physical activity intervention aimed at reducing the risk of diabetes in a community setting in a multi-ethnic population in the UK.

Primary research hypothesis: A pragmatic structured education programme aimed at promoting walking activity initiates long-term increases in physical activity in individuals identified through a risk score as having an increased risk of developing type 2 diabetes.


Options:
A: 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
B: Inclusion Criteria:

The investigators will recruit 315 non-diabetic Veterans receiving primary care at the Ann Arbor VA Medical Center who meet the following inclusion criteria:

* willing to complete a HIPAA authorization form
* no HbA1c results in previous 12 months
* due for VA Primary Care appointment approximately 12 weeks of sending a recruitment letter and who have a body-mass index (BMI) 30 kg/m2
* or BMI 25 kg/m2 with \> 1 obesity-related condition such as:

  * hypertension
  * hyperlipidemia
  * Hypoalphalipoproteinemia
  * Coronary Artery Disease
  * Peripheral Vascular Disease
  * Hypertriglyceridemia
  * past hemoglobin A1c (HbA1c) of 5.7 - 6.4
  * past diagnosis of Impaired Fasting Glucose (IFG)
  * or Impaired Glucose Tolerance (IGT)
  * or Polycystic Ovary Syndrome (PCOS)

Exclusion Criteria:

* The investigators will exclude patients who are \> 75 years of age
* are receiving chemotherapy for cancer, or have:

  * dementia
  * diabetes
  * dementia
  * New York Heart Association Class III or IV congestive heart failure
  * pregnancy
  * Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage 4 Chronic Obstructive Pulmonary Disease (COPD)
  * end-stage renal disease (ESRD)
  * cirrhosis
  * or have been hospitalized or received rehab for stroke or myocardial infarction within the past 6 months
C: Inclusion Criteria:

Screening study: Every one aged 40-69 years (UK and DK) or 50-69 years(NL). Treatment study: All with screen detected type 2 diabetes.

Exclusion Criteria:

Participants are excluded if they already have diabetes at time of screening, are pregnant or lactating or have a severe psychotic illness, are house bound or have an illness with a likely survival of less than one year.
D: Inclusion Criteria:

* 18+
* High risk of developing type 2 diabetes as identified through a risk score

Exclusion Criteria:

* Diagnosed diabetes
* Taking steroid medication
* Serious chronic illness preventing participation in trial
* Unable to speak English

Answer: D