Findings are subject to incomplete reporting and heterogeneity of studies included , and confounding because most included studies used pre-post study design s. CONCLUSIONS DPP lifestyle modification programs achieved clinical ly meaningful weight and cardiometabolic health improvements .
Together , these data suggest that additional value is gained from these programs , reinforcing that they are likely very cost-effective
BACKGROUND The Diabetes Prevention Program ( DPP ) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk .
No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in non research setting s in the United States .
An outpatient-based clinical program for diabetes prevention: an update.
OBJECTIVE To up date outcomes of the Diet-Exercise-Activity-Lifestyle ( DEAL ) program , a clinic-based diabetes prevention intervention . METHODS Changes in weight , fasting blood glucose , and 2-hour glucose after a 75-g oral glucose tolerance test were evaluated in patients who enrolled in the DEAL program between January 2007 and August 2009 . RESULTS The 221 qualified participants had a mean age of 62 years , weight of 87.4 kg , body mass index of 31.2 kg/m² , fasting glucose level of 109 mg/dL , and 2-hour glucose value of 138 mg/dL. Among the program participants , 67 % were women and 88 % were white ; 56 % had isolated impaired fasting glucose , 5 % had impaired glucose tolerance only , and 39 % had both . The 6-month follow-up medical appointment was kept by 72 % of program participants , but only 56 % attended the 12-month visit . By 6 months after baseline , 59 % had significantly lower fasting glucose concentrations , 59 % had improvement in 2-hour glucose levels , and 61 % had weight loss . Nearly 40 % , however , were nonresponders and had increased fasting glucose , 2-hour glucose , and weight by 6 months . By the 12-month visit , significant declines in fasting glucose ( P<.001 ) , 2-hour glucose ( P<.001 ) , and weight ( P = .008 ) occurred in comparison with baseline values ; however , no significant changes occurred in these measures between the 6- and 12-month visits ( P>.30 for all ) . CONCLUSION Most DEAL participants showed improvement in glucose levels and weight , but some patients exhibited worsening glucose intolerance . Factors underlying nonresponse need to be identified . Ongoing experience and analysis should help revise the DEAL program so that outcomes for all participating patients will improve
Findings are subject to incomplete reporting and heterogeneity of studies included , and confounding because most included studies used pre-post study design s. CONCLUSIONS DPP lifestyle modification programs achieved clinical ly meaningful weight and cardiometabolic health improvements .
Together , these data suggest that additional value is gained from these programs , reinforcing that they are likely very cost-effective
BACKGROUND The Diabetes Prevention Program ( DPP ) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk .
No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in non research setting s in the United States .