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 .
Translating the Diabetes Prevention Program lifestyle intervention for weight loss into primary care: a randomized trial.
BACKGROUND The Diabetes Prevention Program ( DPP ) lifestyle intervention reduced the incidence of type 2 diabetes mellitus ( DM ) among high-risk adults by 58 % , with weight loss as the dominant predictor . However , it has not been adequately translated into primary care . METHODS We evaluated 2 adapted DPP lifestyle interventions  among overweight or obese adults who were recruited from 1 primary care clinic and had pre-DM and /or metabolic syndrome . Participants were r and omized to ( 1 ) a coach-led group intervention ( n = 79 ) , ( 2 ) a self-directed DVD intervention ( n = 81 ) , or ( 3 ) usual care ( n = 81 ) . During a 3-month intensive intervention phase , the DPP-based behavioral weight-loss curriculum was delivered by lifestyle coach-led small groups or home-based DVD . During the maintenance phase , participants in both interventions received lifestyle change coaching and support remotely-through secure email within an electronic health record system and the American Heart Association Heart360 website for weight and physical activity goal setting and self-monitoring . The primary outcome was change in body mass index ( BMI ) ( calculated as weight in kilograms divided by height in meters squared ) from baseline to 15 months . RESULTS At baseline , participants had a mean ( SD ) age of 52.9 ( 10.6 ) years and a mean BMI of 32.0 ( 5.4 ) ; 47 % were female ; 78 % , non-Hispanic white ; and 17 % , Asian/Pacific Isl and er . At month 15 , the mean ± SE change in BMI from baseline was -2.2 ± 0.3 in the coach-led group vs -0.9 ± 0.3 in the usual care group ( P < .001 ) and -1.6 ± 0.3 in the self-directed group vs usual care ( P = .02 ) . The percentages of participants who achieved the 7 % DPP-based weight-loss goal were 37.0 % ( P = .003 ) and 35.9 % ( P = .004 ) in the coach-led and self-directed groups , respectively , vs 14.4 % in the usual care group . Both interventions also achieved greater net improvements in waist circumference and fasting plasma glucose level . CONCLUSION Proven effective in a primary care setting , the 2 DPP-based lifestyle interventions are readily scalable and exportable with potential for substantial clinical and public health impact . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00842426
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 .