Abstract
Introduction: Systematic reviews of interventions for diabetes prevention have focused on lifestyle interventions, including the Diabetes Prevention Program (DPP) and translations of the DPP. However, nationally, few people with prediabetes have joined or completed a DPP, with one cited barrier being committing to a yearlong program. This study was a systematic review to evaluate the effectiveness of lower-intensity lifestyle interventions for prediabetes on weight change, glycemia, and health behaviors. Methods: English-language studies from PubMed, Embase, PsycINFO, and CINAHL from 2000 to February 23, 2022 were searched for RCTs of nonpregnant adults with prediabetes and elevated BMI and lower-intensity interventions (defined as ≤12 months and <14 sessions over 6 months). Two reviewers independently identified 11 trials, assessed study quality (using Cochrane risk-of-bias tool), and extracted data serially. A qualitative synthesis was conducted by outcome. Results: Only 1 of 11 trials of lower-intensity interventions was of high quality (>80% follow-up rate and low risk of bias). This 6-month study compared an app with standardized dietary advice, showing a 3-kg greater body weight reduction and 0.2% greater reduction of HbA1c. Discussion: The evidence on lower-intensity lifestyle interventions for diabetes prevention is limited by the small number and methodologic weaknesses of previous trials, and future research is needed in this area. Given the low uptake of and retention in evidence-based high-intensity programs, future work is needed to investigate the effectiveness of novel lower-intensity interventions offered with established DPP content of varying duration and intensity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 906-915 |
| Number of pages | 10 |
| Journal | American Journal of Preventive Medicine |
| Volume | 65 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2023 |
Funding
KM was affiliated with the Johns Hopkins University School of Medicine during the data collection stage and is currently affiliated with the Department of Emergency Medicine at the University of Colorado Anschutz Medical Campus. The study protocol is registered at Open Science Framework: https://osf.io/v4rnq/?view_only=17193a13fe0c40028e4c910eeedebaae. The funding agency had no role in the study design; collection, analysis, interpretation of data; writing of the report; or decision to submit the report for publication. This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (K23DK118205). NMM is a coinventor of a virtual Diabetes Prevention Program, and this program was previously licensed to Johns Hopkins HealthCare but is no longer actively licensed. This program is not mentioned nor evaluated in this paper. No other financial disclosures were reported. This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases ( K23DK118205 ).
ASJC Scopus subject areas
- Epidemiology
- Public Health, Environmental and Occupational Health
