The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians , although few studies reported costs .
Lifestyle interventions are effective in reducing body weight and glucose-related outcomes .
Dietitian-delivered interventions , compared with those delivered by other personnel , achieved greater weight reduction .
No consistent trend was identified across different delivery channels
BACKGROUND Type 2 diabetes is a significant public health concern .
With the completion of the Diabetes Prevention Program , there has been a proliferation of studies attempting to translate this evidence base into practice .
However , the cost , effectiveness , and cost-effectiveness of these adapted interventions is unknown .
OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta- analysis to synthesize the effectiveness , cost , and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent ( dietitian vs non-dietitian ) and channel ( in-person vs technology-delivered ) .
One-Year Results of a Community-Based Translation of the Diabetes Prevention Program
OBJECTIVE Although the Diabetes Prevention Program ( DPP ) and the Finnish Diabetes Prevention Study ( FDPS ) demonstrated that weight loss from lifestyle change reduces type 2 diabetes incidence in patients with prediabetes , the translation into community setting s has been difficult . The objective of this study is to report the first-year results of a community-based translation of the DPP lifestyle weight loss ( LWL ) intervention on fasting glucose , insulin resistance , and adiposity . RESEARCH DESIGN AND METHODS We r and omly assigned 301 overweight and obese volunteers ( BMI 25–40 kg/m2 ) with fasting blood glucose values between 95 and 125 mg/dL to a group-based translation of the DPP LWL intervention administered through a diabetes education program ( DEP ) and delivered by community health workers ( CHWs ) or to an enhanced usual-care condition . CHWs were volunteers with well-controlled type 2 diabetes . A total of 42.5 % of participants were male , mean age was 57.9 years , 26 % were of a race/ethnicity other than white , and 80 % reported having an education beyond high school . The primary outcome is mean fasting glucose over 12 months of follow-up , adjusting for baseline glucose . RESULTS Compared with usual-care participants , LWL intervention participants experienced significantly greater decreases in blood glucose ( −4.3 vs. −0.4 mg/dL ; P < 0.001 ) , insulin ( −6.5 vs. −2.7 μU/mL ; P < 0.001 ) , homeostasis model assessment of insulin resistance ( −1.9 vs. −0.8 ; P < 0.001 ) , weight ( −7.1 vs. −1.4 kg ; P < 0.001 ) , BMI ( −2.1 vs. −0.3 kg/m2 ; P < 0.001 ) , and waist circumference ( −5.9 vs. −0.8 cm ; P < 0.001 ) . CONCLUSIONS This translation of the DPP intervention conducted in community setting s , administered through a DEP , and delivered by CHWs holds great promise for the prevention of diabetes by significantly decreasing glucose , insulin , and adiposity
The cost of intervention per participant delivered by dietitians was lower than interventions delivered by non-dietitians , although few studies reported costs .
Lifestyle interventions are effective in reducing body weight and glucose-related outcomes .
Dietitian-delivered interventions , compared with those delivered by other personnel , achieved greater weight reduction .
No consistent trend was identified across different delivery channels
BACKGROUND Type 2 diabetes is a significant public health concern .
With the completion of the Diabetes Prevention Program , there has been a proliferation of studies attempting to translate this evidence base into practice .
However , the cost , effectiveness , and cost-effectiveness of these adapted interventions is unknown .
OBJECTIVE The purpose of this systematic review was to conduct a comprehensive meta- analysis to synthesize the effectiveness , cost , and cost-effectiveness of lifestyle diabetes prevention interventions and compare effects by intervention delivery agent ( dietitian vs non-dietitian ) and channel ( in-person vs technology-delivered ) .