Weight Loss? Modest With Diabetes Prevention

Purpose: To test the role of financial incentives to motivate engagement in diabetes prevention programs (DPPs). Design: Minnesota, Montana, and New York randomized 3 different approaches to providing incentives: incentivizing class attendance and weight loss (all states), class attendance only (NY), and weight loss only (NY). We used New York to test how different approaches to providing incentives influence DPP completion and attendance. Setting: Health-care facilities and local young men’s Christian association. Participants: Eight hundred thirty one Medicaid enrollees in Minnesota, 204 in Montana, and 560 in New York. Intervention Measure: Impact of the financial incentives on DPP program completion rates. We measured completion of DPP classes in 2 ways: completing 9 or more or 16 or more DPP classes. Analysis: Multivariate logistic model to compare completion of DPP classes between participants randomized into receiving financial incentives and controls. Results: Receipt of incentives was associated with higher odds at attending 9 or more classes (odds ratio [OR]: 2.2; P < .01) in Minnesota, Montana (OR: 2.2; P < .05), and New York (OR: 1.9; P < .01) as well as attending 16 or more classes in Minnesota (OR: 3.1; P < .01), Montana (OR: 2.1; P < .01), and New York (OR: 2.9; P < .01). In New York, individuals paid to attend classes attended more classes than individuals paid based on results only. Conclusion: Among Medicaid beneficiaries, financial incentives improve DPP class attendance.

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Mixed methods pilot study of a low-carbohydrate diabetes prevention programme among adults with pre-diabetes in the USA

BMJ Open ◽

10.1136/bmjopen-2019-033397 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033397 ◽

Cited By ~ 3

Author(s):

Dina Hafez Griauzde ◽

Laura Saslow ◽

Kaitlyn Patterson ◽

Tahoora Ansari ◽

Bradley Liestenfeltz ◽

...

Keyword(s):

Weight Loss ◽

Mixed Methods ◽

Pilot Study ◽

Outcome Measures ◽

Weight Change ◽

Diabetes Prevention ◽

Prevention Programme ◽

Diabetes Prevention Programme ◽

Low Carbohydrate ◽

The Usa

Objectives(1) To estimate weight change from a low-carbohydrate diabetes prevention programme (LC-DPP) and (2) to evaluate the feasibility and acceptability of an LC-DPP.Research designSingle-arm, mixed methods (ie, integration of quantitative and qualitative data) pilot study.SettingPrimary care clinic within a large academic medical centre in the USA.ParticipantsAdults with pre-diabetes and Body Mass Index of ≥25 kg/m2.InterventionWe adapted the Centers for Disease Control and Prevention’s National Diabetes Prevention Program (NDPP)—an evidence-based, low-fat dietary intervention—to teach participants to follow a very low-carbohydrate diet (VLCD). Participants attended 23 group-based classes over 1 year.Outcome measuresPrimary outcome measures were (1) weight change and (2) percentage of participants who achieved ≥5% wt loss. Secondary outcome measures included intervention feasibility and acceptability (eg, attendance and qualitative interview feedback).ResultsOur enrolment target was 22. One person dropped out before a baseline weight was obtained; data from 21 individuals were analysed. Mean weight loss in kilogram was 4.3 (SD 4.8) at 6 months and 4.9 (SD 5.8) at 12 months. Mean per cent body weight changes were 4.5 (SD 5.0) at 6 months and 5.2 (SD 6.0) at 12 months; 8/21 individuals (38%) achieved ≥5% wt loss at 12 months. Mean attendance was 10.3/16 weekly sessions and 3.4/7 biweekly or monthly sessions. Among interviewees (n=14), three factors facilitated VLCD adherence: (1) enjoyment of low-carbohydrate foods, (2) diminished hunger and cravings and (3) health benefits beyond weight loss. Three factors hindered VLCD adherence: (1) enjoyment of high-carbohydrate foods, (2) lack of social support and (3) difficulty preplanning meals.ConclusionsAn LC-DPP is feasible, acceptable and may be an effective option to help individuals with pre-diabetes to lose weight. Data from this pilot will be used to plan a fully powered randomised controlled trial of weight loss among NDPP versus LC-DPP participants.Trial registration numberNCT03258918.

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Is there any conclusive evidence that exercise alone reduces glucose intolerance?

The British Journal of Diabetes ◽

10.1177/1474651403003001s0501 ◽

2003 ◽

Vol 3 (1_suppl) ◽

pp. S18-S23

Author(s):

Arne Astrup

Keyword(s):

Weight Loss ◽

Diabetes Prevention ◽

Intervention Studies ◽

Conclusive Evidence ◽

Regular Exercise ◽

Metabolic Function ◽

Weight Losses ◽

Diet And Exercise ◽

Obese Subjects

Physical activity improves insulin sensitivity and glucose metabolism, although such effects are short-lasting and regular exercise is needed to sustain them. Weight loss, especially loss of visceral fat, appears to be especially important in improving metabolic function and clinical outcomes. The most important consequences of exercise are probably promotion of weight loss and prevention of weight gain. Substantial weight losses, associated with significant improvements in glycaemic control and reductions in the incidence of type 2 diabetes, have been observed in intervention studies in overweight or obese subjects. These benefits were achieved using intensive lifestyle interventions, pharmacotherapy or surgery. Thus, programmes of diet and exercise aimed at achieving control of body weight should play a central role in strategies for diabetes prevention.

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A Community-Based Intervention Reduces Diabetes Risk in a Low-Income Community

Current Developments in Nutrition ◽

10.1093/cdn/nzaa043_006 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 155-155

Author(s):

Jeneen Ali ◽

Shavonnea Brown ◽

Arlene Guindon ◽

Sarah Mills ◽

Alyssa Beavers ◽

...

Keyword(s):

Weight Loss ◽

Low Income ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Program Completion ◽

Diabetes Risk ◽

National Kidney Foundation ◽

Food Bank ◽

Community Based ◽

Paired T Test

Abstract Objectives Promote diabetes prevention in low-income communities by offering Cooking MattersTM (CM) in coordination with the Diabetes Prevention Program (DPP). Reducing food insecurity is necessary for reducing chronic disease rates. DPP is a validated and effective intervention for reducing progression to Type II diabetes, but significant outcome disparities occur in low-income communities. Our research aims to address these outcome disparities. This study is a partnership between Gleaners Community Food Bank (GCFB), National Kidney Foundation of Michigan (NKFM), and Wayne State University. DPP, administered by NKFM, is a community-based intervention that significantly reduces diabetes risk. CM, locally administered through GCFB, is also an effective community program that teaches food skills, and provides food provisions. We hypothesize that combining DPP and CM in a low-income setting will improve program completion, and effectively reduce risk for progressing to Type 2 diabetes. Methods Over 12 months, low-income individuals participated in the combined DPP/CM study. Demographics were collected at the onset of the study. Survey information was collected for diet and physical activity at four time-points throughout the study. Body weight was collected at every session, and HbA1C was collected at the onset and conclusion of the program. Results Combining DPP and CM resulted in a 79% program completion rate. Mean HbA1C dropped 10.6% (paired t-test, P < 0.01), and each participant demonstrated lower post-test HbA1C values. Participants experienced a mean weight loss of 7.6% (paired t-test, P < 0.01), and >75% of participants exceeded the 5% DPP weight loss outcome objective at 12 months. Conclusions Cooking Matters TM coupled with the Diabetes Prevention Program is an effective strategy to improve outcomes and reduce diabetes risk in low-income communities. Food bank resources can be coupled with existing chronic illness prevention programs to improve both disease risk and food security. Funding Sources Gleaners Community Food Bank and National Kidney Foundation of Michigan provided funding for this study.

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