Evidence suggests that pragmatic diabetes prevention programs are effective .
Effectiveness varies substantially between programs but can be improved by maximizing guideline adherence .
OBJECTIVE To summarize the evidence on effectiveness of translational diabetes prevention programs , based on promoting lifestyle change to prevent type 2 diabetes in real-world setting s and to examine whether adherence to international guideline recommendations is associated with effectiveness .
Lifestyle interventions aim ed to translate evidence from previous efficacy trials of diabetes prevention into real-world intervention programs .
Predictors of lifestyle intervention outcome and dropout: the SLIM study
Background / Objectives : To evaluate the effect of a 4.1-year ( range 3–6 years ) lifestyle intervention according to general public health recommendations on glucose tolerance and dropout in a Dutch population with impaired glucose tolerance (IGT).Subjects/ Methods : In the Study on Lifestyle intervention and Impaired glucose tolerance Maastricht , 147 Caucasian IGT subjects were r and omized to an intervention group ( INT : n=74 ; 38 male , 36 female ) and control group ( CON : n=73 ; 37 male , 36 female ) . Annually , subjects underwent measurements of body weight , anthropometry , glucose tolerance ( oral glucose tolerance test ) , insulin resistance ( homeostasis model assessment -insulin resistance ) , maximal aerobic capacity ( VO2 max ) , blood lipids and blood pressure . INT received individual advice regarding a healthy diet and physical activity . Results : INT decreased their saturated fat intake , increased their carbohydrate intake ( P<0.05 ) and VO2 max ( P=0.04 ) compared with CON . Body weight did not change significantly ( P=0.20 ) between the groups . After an initial decrease , 2-h glucose levels overall increased in INT ( + 0.11 mmol/l ) , but significantly less than CON ( + 1.18 mmol/l ; P=0.04 ) . Diabetes incidence was lower in INT versus CON ( 30 versus 56 % , P=0.04 ) . Change in body weight was associated with change in 2-h glucose levels ( β=0.399 mmol/l per kg , P=0.02 ) . Dropouts had a lower aerobic fitness and socioeconomic status , and a higher body mass index ( BMI ) and 2-h glucose compared with non-dropouts . Conclusions : Prolonged feasible changes in diet and physical activity prevent deterioration of glucose tolerance and reduce diabetes risk . Low socioeconomic status , low aerobic fitness and high BMI and 2-h glucose are indicative of dropout to the program
Evidence suggests that pragmatic diabetes prevention programs are effective .
Effectiveness varies substantially between programs but can be improved by maximizing guideline adherence .
OBJECTIVE To summarize the evidence on effectiveness of translational diabetes prevention programs , based on promoting lifestyle change to prevent type 2 diabetes in real-world setting s and to examine whether adherence to international guideline recommendations is associated with effectiveness .
Lifestyle interventions aim ed to translate evidence from previous efficacy trials of diabetes prevention into real-world intervention programs .