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Diabetes Care. 2016 Apr;39(4):525-31. doi: 10.2337/dc15-1899. Epub 2016 Feb 23.

Effective Translation of an Intensive Lifestyle Intervention for Hispanic Women With Prediabetes in a Community Health Center Setting.

Author information

1
Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
2
Fair Haven Community Health Center, New Haven, CT a.camp@fhchc.org.
3
Fair Haven Community Health Center, New Haven, CT.
4
Yale School of Public Health, Yale University, New Haven, CT.

Abstract

OBJECTIVE:

The Diabetes Prevention Program (DPP) demonstrated that weight loss from intensive lifestyle intervention (ILI) in adults with prediabetes could decrease progression to type 2 diabetes. Inner-city, low-income Hispanic women are at high risk for developing type 2 diabetes; however, this type of intervention is not well established in this group. We hypothesized that a DPP intervention modified for a community health center (CHC) setting would decrease weight and improve metabolic measures in Hispanic women with prediabetes.

RESEARCH DESIGN AND METHODS:

Women diagnosed with prediabetes on a screening oral glucose tolerance test were recruited from a CHC. Participants (90% of whom were Hispanic) were randomized to either usual care (age 43 ± 9.7 years, BMI 35.2 ± 7.3 kg/m(2)) or ILI (age 43.8 ± 10.8 years, BMI 35.4 ± 8.5 kg/m(2)), structured as 14 weeks of group sessions focused on food choices, behavior change, physical activity, and weight loss. One year after enrollment, 122 women repeated baseline measures.

RESULTS:

Groups had similar baseline weight, BMI, and fasting and 2-h glucose. One year later, the ILI group had lost 3.8 kg (4.4%), while the usual care group had gained 1.4 kg (1.6%, P < 0.0001). Two-hour glucose excursion decreased 15 mg/dL (0.85 mmol/L) in the ILI and 1 mg/dL (0.07 mmol/L) in the usual care group (P = 0.03). Significant decreases favoring the ILI group were noted in BMI, percent body fat, waist circumference, and fasting insulin.

CONCLUSIONS:

A 14-week ILI program based on the DPP can effectively be translated into a predominantly Hispanic CHC setting, resulting in decreased weight, improved fasting insulin, and smaller glucose excursions 1 year after enrolling in the program.

PMID:
26908915
PMCID:
PMC4806769
DOI:
10.2337/dc15-1899
[Indexed for MEDLINE]
Free PMC Article

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