A significant positive effect of the interventions on weight was reported by all study types .
The meta- analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year .
However , no clear effects on biochemical or clinical parameters were observed , possibly due to short follow-up periods or lack of power of the studies meta-analysed .
Changes in dietary parameters or physical activity were generally not reported .
Most studies assessing feasibility were supportive of implementation of lifestyle interventions in routine clinical care .
Conclusion Lifestyle interventions for patients at high risk of diabetes , delivered by a variety of healthcare providers in routine clinical setting s , are feasible but appear to be of limited clinical benefit one year after intervention .
Despite convincing evidence from structured intensive trials , this systematic review showed that translation into routine practice has less effect on diabetes risk reduction
Background The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from r and omised trials of structured , intensive interventions conducted in several countries over the past two decades .
The challenge is to translate them into routine clinical setting s. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care setting s are feasible and effective in achieving reductions in risk factors for diabetes .
Translating the Diabetes Prevention Program to Primary Care: A Pilot Study
Background : Research on the translation of efficacious lifestyle change programs to prevent type 2 diabetes into community or clinical setting s is needed . Objective : The objective of this study was to examine the reach , implementation , and efficacy of a 6-month lifestyle program implemented in primary care by nurse practitioners ( NPs ) for adults at risk of type 2 diabetes . Methods : The NP sites ( n = 4 ) were r and omized to an enhanced st and ard care program ( one  NP  and one  nutrition session ) or a lifestyle program ( enhanced st and ard care and six NP sessions ) . These NPs recruited adults at risk of diabetes from their practice ( n = 58 ) , with an acceptance rate of 70 % . Results : The program reached a diverse , obese , and moderately low income sample . The NPs were able to successfully implement the protocol s. The average length of the program was 9.3 months . Attendance was high ( 98 % ) , and attrition was low ( 12 % ) . The NPs were able to adopt the educational , behavioral , and psychosocial strategies of the intervention easily . Motivational interviewing was more difficult for NPs . Mixed-model repeated- measures analysis indicated significant trends or improvement in both groups for nutrition and exercise behavior . Participants of the lifestyle program demonstrated trends for better high-density lipoprotein ( HDL ) and exercise behavior compared with the enhanced st and ard care participants . Twenty-five percent of lifestyle participants met treatment goals of 5 % weight loss compared with 11 % of st and ard care participants . Discussion : A lifestyle program can be implemented in primary care by NPs , reach the targeted population , and be modestly successful . Further research is indicated
A significant positive effect of the interventions on weight was reported by all study types .
The meta- analysis showed that lifestyle interventions achieved weight and waist circumference reductions after one year .
However , no clear effects on biochemical or clinical parameters were observed , possibly due to short follow-up periods or lack of power of the studies meta-analysed .
Changes in dietary parameters or physical activity were generally not reported .
Most studies assessing feasibility were supportive of implementation of lifestyle interventions in routine clinical care .
Conclusion Lifestyle interventions for patients at high risk of diabetes , delivered by a variety of healthcare providers in routine clinical setting s , are feasible but appear to be of limited clinical benefit one year after intervention .
Despite convincing evidence from structured intensive trials , this systematic review showed that translation into routine practice has less effect on diabetes risk reduction
Background The clinical effectiveness of intensive lifestyle interventions in preventing or delaying diabetes in people at high risk has been established from r and omised trials of structured , intensive interventions conducted in several countries over the past two decades .
The challenge is to translate them into routine clinical setting s. The objective of this review is to determine whether lifestyle interventions delivered to high-risk adult patients in routine clinical care setting s are feasible and effective in achieving reductions in risk factors for diabetes .