The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians , although few studies reported costs .
Lifestyle interventions are effective in reducing body weight and glucose-related outcomes .
Dietitian-delivered interventions , compared with those delivered by other personnel , achieved greater weight reduction .
No consistent trend was identified across different delivery channels
BACKGROUND Type 2 diabetes is a significant public health concern .
With the completion of the Diabetes Prevention Program , there has been a proliferation of studies attempting to translate this evidence base into practice .
However , the cost , effectiveness , and cost-effectiveness of these adapted interventions is unknown .
OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta- analysis to synthesize the effectiveness , cost , and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent ( dietitian vs non-dietitian ) and channel ( in-person vs technology-delivered ) .
Two-year weight-loss maintenance in primary care-based Diabetes Prevention Program lifestyle interventions
Objective : 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 ) . Design : 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)-r and omized controlled trial , which demonstrated the effectiveness of two adapted Diabetes Prevention Program ( DPP ) lifestyle interventions compared with usual primary care . Subjects : E-LITE r and omized 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 protocol s 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 ) . Results : At month 24 , mean±s.e . changes in body mass index ( trial primary outcome ) and weight ( kg ) from baseline were –1.9±0.3 ( P=0.001 ) and –5.4±0.9 ( P<0.001 ) in the coach-led intervention , and –1.6±0.3 ( P=0.03 ) and –4.5±0.9 ( P=0.001 ) in the self-directed intervention , compared with –0.9±0.3 and 2.4±0.9 in the usual care group . In addition , both interventions led to a greater percentage of participants maintaining ⩾7 % weight loss and sustained improvements in waist circumference and fasting plasma glucose levels than usual care . Conclusion : This study shows sustained benefits of the two primary care-based , technology-mediated DPP lifestyle interventions . The findings warrant replication in long-term studies involving diverse population
The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians , although few studies reported costs .
Lifestyle interventions are effective in reducing body weight and glucose-related outcomes .
Dietitian-delivered interventions , compared with those delivered by other personnel , achieved greater weight reduction .
No consistent trend was identified across different delivery channels
BACKGROUND Type 2 diabetes is a significant public health concern .
With the completion of the Diabetes Prevention Program , there has been a proliferation of studies attempting to translate this evidence base into practice .
However , the cost , effectiveness , and cost-effectiveness of these adapted interventions is unknown .
OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta- analysis to synthesize the effectiveness , cost , and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent ( dietitian vs non-dietitian ) and channel ( in-person vs technology-delivered ) .