scholarly journals Hepatic Fat in Participants With and Without Incident Diabetes in the Diabetes Prevention Program Outcome Study

2021 ◽  
Author(s):  
Ronald B Goldberg ◽  
Mark T Tripputi ◽  
Edward J Boyko ◽  
Matthew Budoff ◽  
Jeanne M Clark ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Waist Circumference ◽  
Fatty Liver ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Liver Fat ◽  
Hepatic Fat ◽  
Diabetes Development

Abstract Purpose To characterize hepatic fat content and fatty liver prevalence, their determinants, and effect of interventions to prevent diabetes using computerized tomography in a cohort with prediabetes, in those developing diabetes versus not. Methods We measured liver fat as liver attenuation (LA) in Hounsfield units in 1876 participants at ~14 years following randomization into the Diabetes Prevention Program, which tested the effects of lifestyle or metformin interventions versus standard care to prevent diabetes. LA was compared among intervention groups and in those with versus without diabetes, and associations with baseline and follow-up measurements of anthropometric and metabolic covariates were assessed. Results There were no differences in liver fat between treatment groups at 14 years of follow-up. Participants with diabetes had lower LA (mean ± SD: 46±16 vs. 51±14HU; p<0.001) and a greater prevalence of fatty liver (LA<40HU) (34% vs 17%; p<0.001). Severity of metabolic abnormalities at the time of LA evaluation were associated with lower LA categories in a graded manner and more strongly in those with diabetes. Averaged annual fasting insulin (an index of insulin resistance [OR, 95% CI 1.76, 1.41-2.20]) waist circumference (1.63, 1.17-2.26), and triglyceride (1.42, 1.13-1.78), but not glucose, were independently associated with LA<40HU prevalence. Conclusions Fatty liver is common in the early phases of diabetes development. The association of LA with insulin resistance, waist circumference and triglyceride levels emphasizes the importance of these markers for hepatic steatosis in this population and that assessment of hepatic fat in early diabetes development is warranted.

Abstract P121: Comparative Effectiveness Study of the Diabetes Prevention Program in Families: Preliminary Results

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jennifer Wessel ◽  
Erin O'Kelly-Phillips ◽  
Kelly Palmer ◽  
Chandan Saha ◽  
Tamara Hannon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Intervention Group ◽  
Diabetes Prevention Program ◽  
Comparative Effectiveness Study ◽  
Develop Type ◽  
History Of ◽  
Family Based

The prevalence of gestational diabetes (GDM) is increasing substantially and currently affects up to 14% of pregnancies. As many as 70% of women with GDM will develop type 2 diabetes (T2D) in the next 10 years. Moreover as many as 40% of children exposed to in-utero diabetes will develop obesity and T2D. The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention that has been shown to lower T2D risk by 58% in high-risk adults. Family based lifestyle interventions that target either children, parents or both have reported mixed results. We modified the DPP curriculum to use with families (DPPF) and recruited mothers with a history of GDM and their children 8-15 years old. We randomized n=130 families to test which method of delivering the DPPF (mothers only (M) or mothers and their children (M+C)) is more effective at lowering families T2D risk. Baseline characteristics of women were similar among each intervention group (n=65 M and n=65 M+C, respectively): age (38±8 vs 39±11, P=0.5), ethnicity (Black 55% vs 55%, White 20% vs 17%, Latino 20% vs 27%, other 5% vs 2%, P=0.6), body mass index (BMI, 37±8 vs 38±7, P=0.24), systolic blood pressure (SBP, 121±11 vs 122±13, P=0.8), diastolic blood pressure (DBP, 103±26 vs 105±21, P=0.6), HbA1c (5.6±0.4 vs 5.7±0.3, p=0.2). The majority of women self-reported low levels of physical activity (PA): moderate PA (2 days or less per week, 42% vs 26%, P=0.06) or vigorous PA (2 days or less per week, 38% vs 25%, P=0.1), and high levels of sedentary activities (3 or more hours per day, 49% vs 58%, P=0.2). For diet related obesogenic behaviors women self-reported high levels of eating meals while watching TV (3 days or more per week, 58% vs 74%, P=.06) and eating at restaurants (3 days or more per week, 28% vs 41%, P=0.1). Follow-up is ongoing and currently n=32 families have completed the 3-month follow-up. Preliminary analyses of mothers show decreases in HbA1c (-.01±.3 vs -.1±.2), SBP (-9.7±30 vs -3.1±8), DBP (-8±19 vs -1±9) but not BMI (0.07±1.6 vs 0.04±1.2); however results were not significantly different by intervention group.

Abstract P381: Diabetes Prevention Program Football Club: A 6-month Intervention Among Latino Men

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jennifer K Frediani ◽  
Jianheng Li ◽  
Felipe Lobelo
Keyword(s):  
Blood Pressure ◽  
Waist Circumference ◽  
Physical Fitness ◽  
Body Mass ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Handgrip Strength ◽  
Diabetes Prevention Program ◽  
Latino Men ◽  
Hispanic Men

Purpose: One third of the U.S. adult population is estimated to have prediabetes. Hispanics have a 50% higher type 2 diabetes (T2DM) death rate compared to non-Hispanic whites, yet low participation in lifestyle change programs, making this subgroup an important target for prevention efforts. The purpose of this study was to determine the effects of an intervention implementing the Center for Disease Control and Prevention (CDC) National Diabetes Prevention Program (NDPP) plus recreational soccer (RS) in Hispanic men. Methods: Overweight and obese Hispanic men, aged 30-57 years with prediabetes at screening were recruited from the community. Enrolled participants were divided into three cohorts. Trained soccer coaches led 30-minute facilitated discussion of the NDPP modules after each RS session, with two sessions per week for 3 months and once per week for the following 3 months. The 1-hour RS sessions followed the Football Fitness curriculum structure. Standardized study assessments included body mass index, waist circumference, multi-frequency bioelectrical impedance analysis (InBody 270), blood pressure, hemoglobin A1c, and validated field physical fitness tests (figure of 8 run, handgrip strength, vertical jump, modified sit-ups, dynamic push-ups, one leg stand and Yo-Yo intermittent sprint test). Mixed models assessed the outcomes as a function of time and cohort and incorporated an unstructured covariance structure to examine the difference between baseline and 6 months. All analyses were conducted as intent-to-treat and generated using SAS v 9.4. Results: Hispanic males (n=41; mean age 41.7 [0.1] years) were obese at baseline (mean BMI 32.7, standard error [0.7], mean weight 93.9 [2.2] kg). After 6 months of the NDPP+RS intervention, there were significant changes in systolic and diastolic blood pressure (-6.6 [2.4]; p=0.01 and -6.1 [1.7] mmHg; p<0.001, respectively), HbA1c -0.2 [0.1]; p=0.005, figure of 8-agility run (-0.5 [0.1] sec; p<0.0001), number of modified push-ups in 40 seconds (3.9 [0.6]; p<0.0001), dynamic sit-ups (1.9 [0.4]; p<0.0001), and predicted VO 2 (ml/kg/min) (0.4 [0.2]; p=0.04. Despite significant reductions in weight (-3.8 kg [0.7]; p<0.0001), waist circumference (-6.6 [0.7] cm; p<0.0001), body fat % (-1.9 kg [0.5]; p=0.0002), lean body mass was mostly preserved [-0.9 [0.3]; p=0.009]. Conclusion: Among middle-aged Latino men, broad-ranging significant improvements in body composition, physical fitness, HbA1c and blood pressure were observed after 6 months of participating in lifestyle education plus RS.

scholarly journals Lifestyle and Metformin Ameliorate Insulin Sensitivity Independently of the Genetic Burden of Established Insulin Resistance Variants in Diabetes Prevention Program Participants

Diabetes ◽  
2015 ◽  
Vol 65 (2) ◽  
pp. 520-526 ◽  
Author(s):  
Marie-France Hivert ◽  
Costas A. Christophi ◽  
Paul W. Franks ◽  
Kathleen A. Jablonski ◽  
David A. Ehrmann ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Diabetes Prevention Program ◽  
Genetic Burden

Empowering Native Adolescents: Responsibility for Their Health Behaviors

2021 ◽  
Vol 45 (1) ◽  
pp. 3-16
Author(s):  
Rachel A. Chambers ◽  
Dane Hautala ◽  
Anne Kenney ◽  
Summer Rosenstock ◽  
Marissa Begay ◽  
...  
Keyword(s):  
Native American ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Latent Class ◽  
Diabetes Prevention Program ◽  
Transition Analysis ◽  
Home Based ◽  
The Impact ◽  
Diabetes And Obesity

Objectives: In this study, we assess the impact of a home-based diabetes prevention program, Together on Diabetes (TOD), on adolescent responsibility-taking for tasks related to diabetes risk. Methods: Participants were Native American youth ages 10-19 with or at risk of type 2 diabetes who participated in a 12-session, 6-month diabetes prevention program with an adult caretaker. Assessments completed at baseline, 6-month, and 12-month follow-up include demographics and the Diabetes and Obesity Task Sharing (DOTS) Questionnaire. We used latent class analysis (LCA) at baseline to examine heterogeneity in DOTS responses. We identified 3 classes (adolescent, shared, caretaker). We used latent transition analysis to examine stability and change in latent status at baseline, 6- and 12-month follow-up. Results: At baseline, the mean age of participants was 13.6 years and 55.9% were boys. From baseline to 6-month follow-up, the adolescent class was most stable, whereas the shared and caretaker classes were less stable. For participants who transition from the adolescent class, most transition to shared class compared to caretaker class. Conclusions: TOD helps to empower Native American adolescents to take responsibility for their health and engage with their caregivers in these decisions.

scholarly journals A Polygenic Lipodystrophy Genetic Risk Score Characterizes Risk Independent of BMI in the Diabetes Prevention Program

2019 ◽  
Vol 3 (9) ◽  
pp. 1663-1677 ◽  
Author(s):  
Shylaja Srinivasan ◽  
Kathleen A Jablonski ◽  
William C Knowler ◽  
Samuel Dagogo-Jack ◽  
Steven E. Kahn ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Risk Score ◽  
Prevention Program ◽  
Genetic Risk ◽  
Diabetes Prevention ◽  
Genetic Risk Score ◽  
Diabetes Prevention Program ◽  
Common Variants ◽  
Lower Weight

Abstract Context There is substantial heterogeneity in insulin sensitivity, and genetics may suggest possible mechanisms by which common variants influence this trait. Objectives We aimed to evaluate an 11-variant polygenic lipodystrophy genetic risk score (GRS) for association with anthropometric, glycemic and metabolic traits in the Diabetes Prevention Program (DPP). In secondary analyses, we tested the association of the GRS with cardiovascular risk factors in the DPP. Design In 2713 DPP participants, we evaluated a validated GRS of 11 common variants associated with fasting insulin-based measures of insulin sensitivity discovered through genome-wide association studies that cluster with a metabolic profile of lipodystrophy, conferring high metabolic risk despite low body mass index (BMI). Results At baseline, a higher polygenic lipodystrophy GRS was associated with lower weight, BMI, and waist circumference measurements, but with worse insulin sensitivity index (ISI) values. Despite starting at a lower weight and BMI, a higher GRS was associated with less weight and BMI reduction at one year and less improvement in ISI after adjusting for baseline values but was not associated with diabetes incidence. A higher GRS was also associated with more atherogenic low-density lipoprotein peak-particle-density at baseline but was not associated with coronary artery calcium scores in the Diabetes Prevention Program Outcomes Study. Conclusions In the DPP, a higher polygenic lipodystrophy GRS for insulin resistance with lower BMI was associated with diminished improvement in insulin sensitivity and potential higher cardiovascular disease risk. This GRS helps characterize insulin resistance in a cohort of individuals at high risk for diabetes, independent of adiposity.

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