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 ) .
Effects of lifestyle intervention in persons at risk for type 2 diabetes mellitus - results from a randomised, controlled trial
Background Lifestyle change is probably the most important single action to prevent type 2 diabetes mellitus . The purpose of this study was to assess the effects of a low-intensity individual lifestyle intervention by a physician and compare this to the same physician intervention combined with an interdisciplinary , group-based approach in a real-life setting . Methods The " Finnish Diabetes Risk score " ( FINDRISC ) was used by GPs to identify individuals at high risk . A r and omised , controlled design and an 18 month follow-up was used to assess the effect of individual lifestyle counselling by a physician ( individual physician group , ( IG ) ) every six months , with emphasis on diet and exercise , and compare this to the same individual lifestyle counselling combined with a group-based interdisciplinary program ( individual and interdisciplinary group , ( IIG ) ) provided over 16 weeks . Primary outcomes were changes in lifestyle indicated by weight reduction ≥ 5 % , improvement in exercise capacity as assessed by VO2 max and diet improvements according to the Smart Diet Score ( SDS ) . Results 213 participants ( 104 in the IG and 109 in the IIG group , 50 % women ) , with a mean age of 46 and mean body mass index 37 , were included ( inclusion rate > 91 % ) of whom 182 returned at follow-up ( drop-out rate 15 % ) . There were no significant differences in changes in lifestyle behaviours between the two groups . At baseline 57 % ( IG ) and 53 % ( IIG ) of participants had poor aerobic capacity and after intervention 35 % and 33 % , respectively , improved their aerobic capacity at least one metabolic equivalent . Unhealthy diets according to SDS were common in both groups at baseline , 61 % ( IG ) and 60 % ( IIG ) , but uncommon at follow-up , 17 % and 10 % , respectively . At least 5 % weight loss was achieved by 35 % ( IG ) and 28 % ( IIG ) . In the combined IG and IIG group , at least one primary outcome was achieved by 93 % while all primary outcomes were achieved by 6 % . Most successful was the 78 % reduction in the proportion of participants with unhealthy diet ( almost 50 % absolute reduction ) . Conclusion It is possible to achieve important lifestyle changes in persons at risk for type 2 diabetes with modest clinical efforts . Group intervention yields no additional effects . The design of the study , with high inclusion and low dropout rates , should make the results applicable to ordinary clinical setting s . Trial registration Clinical Trials.gov :
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 ) .