Advocating for diabetes prevention in older adults

With the aging of the baby-boom generation and increases in life expectancy, the American population is growing older. Aging is associated with adverse changes in glucose tolerance and increased risk of diabetes; the increasing prevalence of diabetes among older adults suggests a clear need for effective diabetes prevention approaches for this population. The purpose of paper is to review what is known about changes in glucose tolerance with advancing age and the potential utility of resistance training (RT) as an intervention to prevent diabetes among middle-aged and older adults. Age-related factors contributing to glucose intolerance, which may be improved with RT, include improvements in insulin signaling defects, reductions in tumor necrosis factor-α, increases in adiponectin and insulin-like growth factor-1 concentrations, and reductions in total and abdominal visceral fat. Current RT recommendations and future areas for investigation are presented.

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Community based diabetes prevention programme in older adults in a Greek rural area

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20161406 ◽

2016 ◽

pp. 1326-1333

Author(s):

Margarita Matte ◽

Konstantinos Makrilakis ◽

Evangelos Polychronopoulos ◽

George Sakellaropoulos ◽

Panagiotis Braoudakis ◽

...

Keyword(s):

Older Adults ◽

Rural Area ◽

Diabetes Prevention ◽

Prevention Programme ◽

Community Based ◽

Diabetes Prevention Programme

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Evaluation of a Diabetes Prevention Program Lifestyle Intervention in Older Adults: A Randomized Controlled Study in Three Senior/Community Centers of Varying Socioeconomic Status

The Diabetes Educator ◽

10.1177/0145721718759982 ◽

2018 ◽

Vol 44 (2) ◽

pp. 118-129 ◽

Cited By ~ 13

Author(s):

M. Kaye Kramer ◽

Karl K. Vanderwood ◽

Vincent C. Arena ◽

Rachel G. Miller ◽

Rebecca Meehan ◽

...

Keyword(s):

Older Adults ◽

Prevention Program ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Controlled Study ◽

Control Group ◽

Community Centers ◽

Cvd Risk ◽

Support Provision ◽

The Metabolic Syndrome

Purpose The purpose of this study is to evaluate the feasibility and effectiveness of an adapted Diabetes Prevention Program (DPP) lifestyle program, DPP Group Lifestyle Balance (GLB), delivered in 3 economically diverse senior/community centers. Methods The DPP-GLB was implemented in 3 senior/community centers in Allegheny County, PA. A 6-month delayed control intervention design was used. Participants were randomized to begin the DPP-GLB immediately (immediate) or after a 6-month delay (delayed). Adults (n = 134; mean age = 62.8 years) with BMI ≥24 kg/m2 and prediabetes and/or the metabolic syndrome took part. Weight, physical activity (PA), and diabetes and cardiovascular disease (CVD) risk factors were assessed at 6, 12, and 18 months from baseline. Results At 6 months, the immediate group demonstrated greater mean weight loss than the delayed control group as well as significantly greater improvements in PA, A1C, fasting insulin, and waist circumference. In pre-post analyses, both randomized groups showed similar success that was maintained at 18 months. Conclusions The DPP-GLB delivered in economically diverse community centers was effective in this group of older adults. These findings support provision of coverage for prevention programs in older adults at risk for diabetes/CVD, which is important considering the large number of individuals who will be Medicare eligible in the near future.

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Comparative Effectiveness of Three Different Delivery Models for a Community-Based Diabetes Prevention and Management Education Program in Older Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa060_005 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1367-1367

Author(s):

Yasaman Jamshidi-Naeini ◽

Wilna Oldewage-Theron

Keyword(s):

Older Adults ◽

Self Efficacy ◽

Diabetes Prevention ◽

Peer Groups ◽

Community Dwelling ◽

Dietary Behaviors ◽

Written Materials ◽

To Receive ◽

Delivery Models ◽

Passive Group

Abstract Objectives The purpose was to compare the effects of three different delivery models for a diabetes prevention and management education (DPME) program on nutrition and diabetes knowledge (NDK), self-efficacy, dietary behaviors, skin carotenoid score (SCS), Body Mass Index (BMI), and fasting plasma glucose (FPG) among older adults. Methods We investigated dietary perceptions and health education needs of the community-dwelling older persons through interviewer-administered questionnaires in Lubbock, Texas (n = 186). This was then used to modify the national Diabetes Prevention Program (DPP), where the core elements were healthy eating within limited budget, enhancing self-efficacy, nutrition misconceptions, and practical problem-solving skills. The intervention was a clustered randomized trial (CRT). We recruited six community centers (two blocks of three). Two centers were randomly assigned to receive DPME through education and support from nutrition professionals (Pro, n = 23), two centers were assigned to trained peer educators (Peer, n = 27), and two centers were assigned to receive written materials (Passive, n = 26). Pro and Peer groups received weekly 45-minuate DPME sessions and the written materials for 10 weeks. Passive group received the DPME written materials on a weekly basis. Outcome measures were assessed at baseline and at the end of the intervention. Results The majority of subjects were Hispanics (72.4%), followed by Caucasians (14.5%) and African Americans (11.8%). Regression models demonstrated a significant improvement in self-efficacy score in Peer group (+0.38 ± 0.24) compared to the other two groups (+0.18 ± 0.32 for Pro and +0.11 ± 0.45 for Passive, P < 0.05). We found significant within-group improvements in NDK (P < 0.01), SCS (P < 0.001), and dietary behaviors (P < 0.001) for both Pro and Peer groups, with no significant differences between the two groups. Passive group did not show any significant changes in any of the outcomes measures. Budget management strategies were the most frequently reported element that empowered participants for changing their dietary behaviors. Conclusions Peer education provides a sustainable resource for diabetes prevention programs for community-dwelling elderly people. Passive information dissemination had no benefits to diabetes prevention for older adults. Funding Sources TTU Start-Up Funds.

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517-P: Cardiometabolic Benefits in Older Adults with Metabolic Syndrome after Diabetes Prevention Program (DPP)-Based Lifestyle Intervention

Diabetes ◽

10.2337/db21-517-p ◽

2021 ◽

Vol 70 (Supplement 1) ◽

pp. 517-P

Author(s):

HARRISON J. STERN ◽

RACHEL G. MILLER ◽

TREVOR J. ORCHARD ◽

TINA COSTACOU ◽

ELIZABETH M. VENDITTI

Keyword(s):

Older Adults ◽

Metabolic Syndrome ◽

Lifestyle Intervention ◽

Prevention Program ◽

Diabetes Prevention ◽

Diabetes Prevention Program

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Participation and weight loss in online National Diabetes Prevention Programs: a comparison of age and gender subgroups

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa048 ◽

2020 ◽

Cited By ~ 1

Author(s):

Katherine A Sauder ◽

Natalie D Ritchie ◽

Byron Crowe ◽

Edith Cox ◽

Marissa Hudson ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Early Onset ◽

Diabetes Prevention ◽

Prevention Programs ◽

Older Men ◽

Reproductive Age ◽

Transgenerational Effects ◽

Younger Adults ◽

Younger Men

Abstract Early onset diabetes has adverse transgenerational effects, yet in-person National Diabetes Prevention Programs (NDPPs) have low reach among adults of peak reproductive age. We examined participation and weight loss with online NDPPs for younger versus older adults. Solera Health, Inc., collected data from 12,966 adults who enrolled in a yearlong online NDPP from 2015 to 2018. We used general linear models and logistic regression to assess differences between younger and older adults (<45 vs. ≥45 years) in session initiation (logging in), session completion (activities approximating intensity of in-person classes), and weight loss, overall and according to engagement thresholds. Almost all (N = 12,497, 96%) individuals who enrolled initiated ≥1 session(s), but fewer (N = 2,408, 19%) completed ≥4 sessions over ≥9 months, achieving 4.5% weight loss on average. Among all enrollees with ≥2 weights (N = 10,161), younger men and women lost less weight (1.8% and 1.7%, respectively) than older men (3.3%) and women (2.7%; all p < .05). Among all enrollees who completed ≥4 sessions over ≥9 months, weight loss did not differ between older men (4.3%), older women (4.0%), and younger men (3.5%), but younger women achieved less weight loss (3.0%) than older adults (all p < .001). Online programming supports NDPP reach and weight loss, although younger adults completed fewer sessions and young women achieved less weight loss than older adults. Efforts to increase ongoing engagement among younger adults are needed to prevent early onset of diabetes and adverse transgenerational effects.

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LEVERAGING COMMUNITIES AS NETWORKS TO REDUCE MALNUTRITION IN OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.834 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S226-S227

Author(s):

Tina Sadarangani ◽

Jeannette Beasley ◽

Shannon E Jarrott

Keyword(s):

Older Adults ◽

At Risk ◽

Asian American ◽

Prevention Program ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Adverse Outcomes ◽

Community Dwelling ◽

Community Based ◽

Community Dwelling Older Adults

Abstract Malnutrition in older adults, while ubiquitous, remains largely underrecognized and undertreated. In community-dwelling older adults, 25% of those at risk of over or under nutrition do not receive any dietary interventions; routine screenings for malnutrition are not typically required in community-based settings. In this interdisciplinary symposium, we explore issues focused on the delivery of evidence-based nutrition interventions to meet the needs of community-dwelling older adults. Using national survey data, we begin by underscoring the importance of treating the complex needs of adults at risk of malnutrition by examining health sequelae, specifically hospitalizations, in community-dwelling adults receiving home-delivered meals. We subsequently examine approaches to malnutrition screening in community-based settings, focusing on the utility of the DETERMINE checklist. We explore barriers and facilitators of providing person-centered nutrition to ethnically diverse Asian American older adults in the adult day healthcare setting. Finally, we shift our focus to overnutrition, discussing the dissemination of a telehealth diabetes prevention program, BRInging the Diabetes prevention program to GEriatric populations (BRIDGE) among older adult meal program recipients. Older adults in community-based health settings are at risk of malnutrition, and among them, those who are prone to social isolation, are at highest risk for adverse outcomes. While congregate settings can facilitate social interaction, honoring food preferences and facilitating choice to address undernutrition, is challenging. Conversely, telehealth interventions may present a feasible approach for addressing overnutrition. We conclude by discussing how current and future research can inform innovative person-centered community-based approaches to identify and treat malnutrition.

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BRInging the Diabetes prevention program to GEriatric populations (BRIDGE): a feasibility study

Pilot and Feasibility Studies ◽

10.1186/s40814-019-0513-7 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Jeannette M. Beasley ◽

Lindsey Kirshner ◽

Judith Wylie-Rosett ◽

Mary Ann Sevick ◽

Laura DeLuca ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Focus Group ◽

Prevention Program ◽

Behavioral Interventions ◽

Diabetes Prevention ◽

Diabetes Prevention Program ◽

Senior Center ◽

Attendance Rates ◽

Activity Trackers

Abstract Background The purpose of this 6-week intervention was to test the feasibility and acceptability of implementing a telehealth-adapted Diabetes Prevention Program (DPP) at a senior center. Methods Older adults (n = 16) attended weekly interactive webinars. At each measurement time point, participants completed questionnaires covering lifestyle, physical activity, quality of life, and food records and wore physical activity trackers. Qualitative data were gathered from 2 focus groups inviting all 16 participants with 13 and 10 participants attending, respectively. Results Over 2000 senior center members were contacted, approximately 2% (n = 39) responded to the recruitment email, and 16 were recruited into the study. Retention was 75%, and attendance rates averaged 80% across the six intervention sessions. The focus group participants provided positive opinions for most program components, especially the webinar group interaction and using physical activity trackers. Suggestions for improvement included a greater focus on specific needs of older adults (i.e., adapting activities) and placing a greater emphasis on dietary strategies to prevent diabetes. Mean weight loss was 2.9% (2.7 kg [95% CI 1.6, 3.7]; p value = 0.001). Conclusion The feasibility of providing DPP via webinar appears to be high based on the retention and attendance rates. Similar to other behavioral interventions engaging older adults, recruitment rates were low. Acceptability was evidenced by high attendance at the intervention sessions and feedback from participants during focus group sessions. The intervention efficacy should be evaluated based on CDC criteria for program recognition in a larger scale randomized trial. Trial registration NCT03524404. Registered 14 May 2018—retrospectively registered. Trial protocol will be provided by the corresponding author upon request.

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