Genetic Markers Explain Differences in HbA1c Levels between African-American (AA) and Non-Hispanic White (NHW) Participants of the Diabetes Prevention Program (DPP)

Purpose: Previous DPP translations in African American women have been suboptimal. This trial evaluated a community-based participatory research developed faith-based diabetes prevention program (DPP) to improve weight loss in African American women. Design: This cluster randomized trial allocated churches to faith-based (FDPP) or standard (SDPP) DPP interventions. Setting. African American churches. Subjects. Eleven churches with 221 African American women (aged 48.8 ± 11.2 years, BMI = 36.7 ± 8.4) received the FDPP (n = 6) or SDPP (n = 5) intervention. Intervention: FDPP incorporated 5 faith-based components, including pastor involvement, into the standard DPP curriculum. The SDPP used the standard DPP curriculum. Lay health leaders facilitated interventions at church sites. Measures: Weight and biometrics were collected by blinded staff at baseline, 4- and 10-months. Analysis: A multilevel hierarchical regression model compared the FDPP and SDPP groups on outcomes. Results: FDPP and SDPP churches significantly lost weight at 10-months (overall −2.6%, p < .01). Women in FDPP churches who attended at least 15 sessions lost an additional 6.1 pounds at 4-months compared to SDPP corresponding to a 5.8% reduction at 10-months (p < .05). Both groups had significant improvements in health behaviors and biometrics. Conclusions: Faith-based and standard DPP interventions led by lay health leaders successfully improved weight, health behaviors, and chronic disease risk. However, the faith-based DPP when fully implemented met the CDC’s recommendation for weight loss for diabetes prevention in African American women.

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Mobile Delivery of the Diabetes Prevention Program in People With Prediabetes: Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/17842 ◽

2020 ◽

Vol 8 (7) ◽

pp. e17842

Author(s):

Tatiana Toro-Ramos ◽

Andreas Michaelides ◽

Maria Anton ◽

Zulekha Karim ◽

Leah Kang-Oh ◽

...

Keyword(s):

Weight Loss ◽

Prevention Program ◽

Diabetes Prevention ◽

Controlled Trial ◽

Intervention Group ◽

Diabetes Prevention Program ◽

Control Group ◽

Significant Weight Loss ◽

Randomized Controlled ◽

Hba1c Levels

Background The Centers for Disease Control and Prevention (CDC) diabetes prevention program (DPP) has formed the foundation for Type 2 Diabetes Mellitus (T2DM) prevention efforts and lifestyle change modifications in multiple care settings. To our knowledge, no randomized controlled trial has verified the efficacy of a fully mobile version of CDC’s diabetes prevention program (DPP). Objective This study aimed to investigate the long-term weight loss and glycemic efficacy of a mobile-delivered DPP compared with a control group receiving usual medical care. Methods Adults with prediabetes (N=202) were recruited from a clinic and randomized to either a mobile-delivered, coach-guided DPP (Noom) or a control group that received regular medical care including a paper-based DPP curriculum and no formal intervention. The intervention group learned how to use the Noom program, how to interact with their coach, and the importance of maintaining motivation. They had access to an interactive coach-to-participant interface and group messaging, daily challenges for behavior change, DPP-based education articles, food logging, and automated feedback. Primary outcomes included changes in weight and hemoglobin A1c (HbA1c) levels at 6 and 12 months, respectively. Exploratory secondary outcomes included program engagement as a predictor of changes in weight and HbA1c levels. Results A total of 202 participants were recruited and randomized into the intervention (n=101) or control group (n=99). In the intention-to-treat (ITT) analyses, changes in the participants’ weight and BMI were significantly different at 6 months between the intervention and control groups, but there was no difference in HbA1c levels (mean difference 0.004%, SE 0.05; P=.94). Weight and BMI were lower in the intervention group by −2.64 kg (SE 0.71; P<.001) and −0.99 kg/m2 (SE 0.29; P=.001), respectively. These differences persisted at 12 months. However, in the analyses that did not involve ITT, program completers achieved a significant weight loss of 5.6% (SE 0.81; P<.001) at 6 months, maintaining 4.7% (SE 0.88; P<.001) of their weight loss at 12 months. The control group lost −0.15% at 6 months (SE 0.64; P=.85) and gained 0.33% (SE 0.70; P=.63) at 12 months. Those randomized to the intervention group who did not start the program had no meaningful weight or HbA1c level change, similar to the control group. At 1 year, the intervention group showed a 0.23% reduction in HbA1c levels; those who completed the intervention showed a 0.28% reduction. Those assigned to the control group had a 0.16% reduction in HbA1c levels. Conclusions This novel mobile-delivered DPP achieved significant weight loss reductions for up to 1 year compared with usual care. This type of intervention reduces the risk of overt diabetes without the added barriers of in-person interventions. Trial Registration ClinicalTrials.gov NCT03865342; https://clinicaltrials.gov/ct2/show/NCT03865342

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Effect of the National Diabetes Prevention Program on Weight Loss for English- and Spanish-Speaking Latinos

American Journal of Health Promotion ◽

10.1177/0890117117698623 ◽

2017 ◽

Vol 32 (3) ◽

pp. 812-815 ◽

Cited By ~ 17

Author(s):

Natalie D. Ritchie ◽

Liesel Christoe-Frazier ◽

Kim K. McFann ◽

Edward P. Havranek ◽

Rocio I. Pereira

Keyword(s):

Weight Loss ◽

Prevention Program ◽

Diabetes Prevention ◽

Body Weight Loss ◽

Diabetes Prevention Program ◽

Spanish Language ◽

Analysis Of Covariance ◽

No Weight Loss ◽

Control Cohort Study ◽

Hispanic White

Purpose: To study the effect of the National Diabetes Prevention Program (NDPP) on weight loss in Latinos. Design: No-control, cohort study comparing Latino and non-Hispanic white (NHW) participants. Setting: A health-care system. Participants: Five hundred sixty-seven Latino and 175 NHW patients who enrolled in the NDPP. A total of 45.2% of Latinos selected the Spanish-language NDPP. Intervention: The NDPP is a nationwide translation of a clinical trial and seeks to prevent diabetes through weight loss in a yearlong group program. Measures: Independent variables included ethnicity, class language, and number of sessions attended. Main outcomes were initial attendance, number of sessions attended, and weight loss. Analysis: Multivariate logistic regression and analysis of covariance were used to determine differences in NDPP outcomes by ethnicity, language, and number of sessions attended. Results: Mean attendance was 8.60 of 22 sessions. Each session was associated with 0.30% (±0.02; P < .001) body weight loss. Latinos were half as likely to attend as NHWs, odds ratio 0.52 ( P < .001). Latino attendees came to 2.67 ± 0.63 ( P < .001) fewer sessions than NHWs. There were no weight loss differences by ethnicity after controlling for attendance. Outcomes did not differ among Latinos in the English- and Spanish-language NDPP. Conclusion: Latinos appeared to benefit less from the NDPP compared to NHWs, likely due to lower attendance rates. Further efforts are needed to support their participation.

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