A lifestyle intervention study in patients with diabetes or impaired glucose tolerance: translation of a research intervention into practice.

摘要

OBJECTIVE: The objectives of this study were to translate a research-validated lifestyle modification curriculum of the Diabetes Prevention Program (DPP) into a community-based program delivered by trained graduate students on a university campus and determine whether this delivery approach is effective in lowering risk factors of type 2 diabetes in at-risk adults. METHODS: A convenience sample of 29 prediabetic or type 2 diabetic patients completed a 12-month behavior modification intervention to achieve and maintain at least 7% weight loss and become more active. Changes in weight, waist and hip circumferences, blood pressure, metabolic biomarkers, physical activity levels, and medication were assessed. RESULTS: At 6 and 12 months, 39% and 56% of patients had lost > or =5% of their weight. The mean weight loss at 12 months was 6%. Significant improvements were noted in most other anthropometric measurements and diastolic BP (-4.1 mm Hg). Significant reductions in total cholesterol (-11.7%), LDL-C (-7.6%), and HDL-C (-6.5%) were observed by 6 months but not at 12 months. Fasting glucose (-12%), systolic BP (-8.4 mm Hg), and diastolic BP (-7.0 mm Hg) were significantly improved in a subgroup of participants with at least 5% weight loss. HbA1c levels were associated with percentage weight loss. Twenty-seven percent of participants on diabetes medication had their drug discontinued. CONCLUSION: Weight-related findings of this study are comparable with those of the DPP. DPP curriculum implemented in a nonclinical setting can help some adults at-risk for or in early stages of diabetes improve anthropometric and certain metabolic outcomes.