D and PA+D  interventions had larger effects on glucose reduction  than PA alone .
Lifestyle  interventions significantly improved FPG , HbA1c , FI , HOMA-IR , and bodyweight among adults without IGT or diabetes , and might reduce progression of hyperglycemia to type 2 diabetes mellitus
This study systematic ally assessed the effectiveness of lifestyle interventions on glycemic indicators among adults ( ⩾18years ) without IGT or diabetes .
Randomized clinical trial of lifestyle interventions in Pima Indians: a pilot study.
A pilot trial was conducted to test adherence to specific lifestyle interventions among Pima Indians of Arizona , and to compare them for changes in risk factors for diabetes mellitus . Ninety-five obese , normoglycaemic men and women , aged 25 - 54 years , were r and omized to treatments named ' Pima Action ' ( Action ) and ' Pima Pride ' ( Pride ) , which were tested for 12 months . Action involved structured activity and nutrition interventions , and Pride included unstructured activities emphasizing Pima history and culture . Adherence to interventions , changes in self-reported activity and diet , and changes in weight , glucose concentrations , and other risk factors were assessed regularly . Thirty-five eligible subjects who had declined r and omization were also followed as an ' observational ' group and 22 members of this group were examined once at a median of 25 months for changes in weight and glucose concentration . After 12 months of intervention , members of both intervention groups reported increased levels of physical activity ( median : Action 7.3 h month(-1 ) , Pride 6.3 h month(-1 ) , p < 0.001 for each ) , and Pride members reported decreased starch intake ( 28 g , p = 0.008 ) . Body mass index , systolic and diastolic blood pressures , weight , 2-h glucose and 2-h insulin had all increased in Action members ( p < 0.003 for each ) , and waist circumference had decreased in Pride members ( p = 0.05 ) . Action members gained more weight than Pride members ( 2.5 kg vs 0.8 kg , p = 0.06 ) , and had a greater increase in 2-h glucose than Pride members ( 1.33 mM vs 0.03 mM , p = 0.007 ) . Members of the observational group gained an average of 1.9 kg year(-1 ) in weight and had an increase of 0.36 mM year(-1 ) in 2-h glucose . Sustaining adherence in behavioural interventions over a long term was challenging . Pimas may find a less direct , less structured , and more participative intervention more acceptable than a direct and highly structured approach
D and PA+D  interventions had larger effects on glucose reduction  than PA alone .
Lifestyle  interventions significantly improved FPG , HbA1c , FI , HOMA-IR , and bodyweight among adults without IGT or diabetes , and might reduce progression of hyperglycemia to type 2 diabetes mellitus
This study systematic ally assessed the effectiveness of lifestyle interventions on glycemic indicators among adults ( ⩾18years ) without IGT or diabetes .