Tawazon- An Intensive Lifestyle Diabetes Prevention Program: The Saudi Arabian Pilot

Background: Lifestyle modification interventions help prevent or postpone Type 2 Diabetes and its complications with diet modification and increasing physical activity. This is translational research of Tawazon-DPP in which we evaluate the efficacy of the intensive lifestyle modification program.

Methods: Tawazon was piloted in 2 phases over 6 and 9 months at a Tertiary Hospital. Phase I was conducted in 2017 in one district facility with 47 participants while Phase II was conducted in 2018 in 4 district facilities with 247 participants. Data are collected retrospectively in a before-and-after study design. The program included adults with 25 kg/m² BMI and HbA1c ranging between 5.7 and 6.4 mmol/L, while excluding participants with comorbidities, such as cardiovascular conditions, musculoskeletal injuries, and pregnancy.

Results: We used descriptive analysis as well as Wilcoxon rank sign test and McNemar-Bowker for before and after data comparisons. Phase I exhibited a mean age of 43±7 years and statistically significant improvement in HbA1c (0.3 mmol/L), weight (3.3 kg), BMI (1 kg/m²), triglyceride (30.4 mg/dL) and LDL (14.67 mg/dL). Phase II exhibited a mean age of 45±9 years with 70% above 40 years old. Significant improvement was also found in HbA1c (0.2 mmol/L), weight (5.1 kg), and BMI (1.8 kg/m²); the lipid profile in the second phase showed better results with significant improvement in total cholesterol (7.4 mg/dL), triglyceride (20.9 mg/dL), LDL (8.8 mg/dL), and (0.9 mg/dL) increase in HDL.

Conclusion: This pilot has taken lifestyle interventions to real-life and it led to the favored and desired outcome. It showed that long-term guided support can help patients make the needed changes in their diet, habits, and physical activity, thus, prevent or delay the onset of Type 2 diabetes.