Maintaining The Benefits Of A 'Real-world' Diabetes Prevention Program: Effect Of A Supplementary Lifestyle Program

Abstract

PURPOSE: To determine the effectiveness of a supplementary lifestyle program to maintain the benefits previously achieved in a 'real-world' intervention by adults at risk of developing type 2 diabetes. METHODS: 37 adults (31 f, 6 m) participated in the 1-y program 2-y after the completion of an initial 1-y group-based lifestyle (diet and exercise) intervention for individuals at high risk of developing type 2 diabetes. The intervention and program were based upon self management principles. The program was designed to meet the participant needs. It included 2, 2-h face-to-face 'refresher' sessions and individualised written support. Data were gathered at baseline, completion of the 1-y intervention, and at the beginning and end of the 1-y program. Variables measured included: Fasting Plasma Glucose (FPG) (mmol·L-1), 2-h Plasma Glucose (2h-PG) (mmol·L-1), Systolic (SBP) and Diastolic (DBP) blood pressure (mmHg), body weight (BW) (kg), physical activity (PA) (weighted min·week-1), total energy intake (kJ·day-1), dietary saturated fat (%), sit to stand (total count) and 2-min step test (total count). Data were analysed using ANOVA with Intention-to-treat (p<0.05). RESULTS: In the 2-y period after the 1-y intervention, significant partial reversals occurred in FPG, BW, total energy intake, sit to stand and 2-min step test. Notable exceptions were 2h-PG, SBP, DBP and PA. During the program, significant improvements occurred in most variables except 2-min step test. A notable exception was 2h-PG, for which very little change occurred in the mean value following the initial intervention. Overall, significant improvements from baseline were sustained throughout the 4-y period in SBP and DBP, BW, total energy intake and dietary saturated fat. The significant reduction in 2h-PG achieved during the initial program was also sustained, although significance was only attained after the program. For a further 3 measures (FPG, PA, sit to stand) significant improvement was achieved in the initial intervention, lost in the intervening period and regained in the supplementary program. CONCLUSIONS: A 12-month program can effectively maintain or re-establish the reduction in diabetes risk factors initially gained in a 'real-world' diabetes prevention program.