Small effect sizes and potentially transient effect were reported in some studies , and some review ers noted that durability of intervention impact was potentially sensitive to duration of intervention and adherence to behaviour change .
Behaviour change , vascular disease and mortality outcome data were infrequently reported , and evidence of the impact of intervention on these outcomes was minimal .
Relatively long- duration lifestyle interventions can limit or delay progression to diabetes under trial conditions .
However , outcomes from more time-limited interventions , and those applied in routine clinical setting s , appear more variable , in keeping with the findings of recent pragmatic trials .
There is little evidence of intervention impact on vascular outcomes or mortality end points in any context . '
Real-world ' implementation of lifestyle interventions for diabetes prevention may be expected to lead to modest outcomes
OBJECTIVES To review the clinical outcomes of combined diet and physical activity interventions for population s at high risk of type 2 diabetes .
Effective Translation of an Intensive Lifestyle Intervention for Hispanic Women With Prediabetes in a Community Health Center Setting
OBJECTIVE The Diabetes Prevention Program ( DPP ) demonstrated that weight loss from intensive lifestyle intervention ( ILI ) in adults with prediabetes could decrease progression to type 2 diabetes . Inner-city , low-income Hispanic women are at high risk for developing type 2 diabetes ; however , this type of intervention is not well established in this group . We hypothesized that a DPP intervention modified for a community health center ( CHC ) setting would decrease weight and improve metabolic measures in Hispanic women with prediabetes . RESEARCH DESIGN AND METHODS Women diagnosed with prediabetes on a screening oral glucose tolerance test were recruited from a CHC . Participants ( 90 % of whom were Hispanic ) were r and omized to either usual care ( age 43 ± 9.7 years , BMI 35.2 ± 7.3 kg/m2 ) or ILI ( age 43.8 ± 10.8 years , BMI 35.4 ± 8.5 kg/m2 ) , structured as 14 weeks of group sessions focused on food choices , behavior change , physical activity , and weight loss . One year after enrollment , 122 women repeated baseline measures . RESULTS Groups had similar baseline weight , BMI , and fasting and 2-h glucose . One year later , the ILI group had lost 3.8 kg ( 4.4 % ) , while the usual care group had gained 1.4 kg ( 1.6 % , P < 0.0001 ) . Two-hour glucose excursion decreased 15 mg/dL ( 0.85 mmol/L ) in the ILI and 1 mg/dL ( 0.07 mmol/L ) in the usual care group ( P = 0.03 ) . Significant decreases favoring the ILI group were noted in BMI , percent body fat , waist circumference , and fasting insulin . CONCLUSIONS A 14-week ILI program based on the DPP can effectively be translated into a predominantly Hispanic CHC setting , result ing in decreased weight , improved fasting insulin , and smaller glucose excursions 1 year after enrolling in the program
Small effect sizes and potentially transient effect were reported in some studies , and some review ers noted that durability of intervention impact was potentially sensitive to duration of intervention and adherence to behaviour change .
Behaviour change , vascular disease and mortality outcome data were infrequently reported , and evidence of the impact of intervention on these outcomes was minimal .
Relatively long- duration lifestyle interventions can limit or delay progression to diabetes under trial conditions .
However , outcomes from more time-limited interventions , and those applied in routine clinical setting s , appear more variable , in keeping with the findings of recent pragmatic trials .
There is little evidence of intervention impact on vascular outcomes or mortality end points in any context . '
Real-world ' implementation of lifestyle interventions for diabetes prevention may be expected to lead to modest outcomes
OBJECTIVES To review the clinical outcomes of combined diet and physical activity interventions for population s at high risk of type 2 diabetes .