Long-term effects of a community-based lifestyle intervention to prevent type 2 diabetes: the DEPLOY extension pilot study

Abstract

The US Diabetes Prevention Program (DPP) and other large trials internationally have shown that an intensive lifestyle intervention can reduce the development of type 2 diabetes. We evaluated long-term effects of a lower cost, group-based adaption of the DPP lifestyle intervention offered by the YMCA. Participants were adults with BMI ≥24 kg/m(2) and random capillary blood glucose 6.1-11.1 mmol/L who had been previously enrolled in a cluster-randomized trial comparing a group-based DPP lifestyle intervention versus brief advice alone. Four to 12 months after completion of the initial trial, 72% of 92 participants enrolled in an extension study, and all were offered a group lifestyle maintenance program at the YMCA. Paired t-tests were used to assess within-group changes; ANCOVA with adjustment was used for between-group comparisons. At 28 months, after both arms were offered the same 8-month lifestyle maintenance intervention, both arms had statistically significant weight losses compared to baseline (brief advice controls: -3.6%; 95% CI: -5.8 to -1.4; intensive lifestyle: -6.0%; 95% CI: -8.8 to -3.2). Participants initially assigned to the DPP also experienced significant improvements in blood pressure and total cholesterol. The YMCA is a promising channel for dissemination of a low-cost model for lifestyle diabetes prevention. Future studies are needed to verify these findings.