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A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial
Open accessAbstract
Objectives Prevention of type 2 diabetes (T2DM) is a priority in healthcare, but there is a lack of evidence investigating how to effectively translate prevention research into a UK primary care setting. We assessed whether a structured education programme targeting lifestyle and behaviour change was effective at preventing progression to T2DM in people with pre-diabetes.Materials and methods Forty-four general practices were randomised to receive either standard care or a 6hour group structured education programme with an annual refresher course, and regular phone contact. Participants were followed up for 3years. The primary outcome was progression to T2DM.Results Eight hundred and eighty participants were included (36% female, mean age 64years, 16% ethnic minority group); 131 participants developed T2DM. There was a non-significant 26% reduced risk of developing T2DM in the intervention arm compared to standard care (HR 0.74, 95% CI 0.48, 1.14, p=0.18). The reduction in T2DM risk when excluding those who did not attend the initial education session was also non-significant (HR 0.65, 0.41, 1.03, p=0.07). There were statistically significant improvements in HbA1c (-0.06, -0.11, -0.01), LDL cholesterol (-0.08, -0.15, -0.01), sedentary time (-26.29, -45.26, -7.32) and step count (498.15, 162.10, 834.20) when data were analysed across all time points.Conclusions This study suggests that a relatively low resource, pragmatic diabetes prevention programme resulted in modest benefits to biomedical, lifestyle and psychosocial outcomes, however the reduction to the risk of T2DM did not reach significance. The findings have important implications for future research and primary care.
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“Analysis of the RETURN intervention suggested an estimated probability of cost- effectiveness of well over 90%, substantially exceeding these examples”
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“(4) For example, the Finnish Diabetes Prevention Study (DPS) found that the risk of T2DM was reduced by 58% in those referred to an intensive lifestyle intervention compared to usual care over a three-year period.(5) Consistent findings have been reported from the USA Diabetes Prevention Program (DPP).”
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Metadata
- Authors
- Davies, M. J., Gray, L. J., Troughton, J., Gray, A., Tuomilehto, J., Farooqi, A., Khunti, K., & Yates, T.
- Affiliations
- University of Leicester (GB)
- University of Oxford (GB)
- Universität für Weiterbildung Krems (AT)
- Corresponding author
- Gray, Laura J.
- ORCID
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 84
- Pages
- 48-56
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2202989893
- Cited by
- 123
- References
- 36
- Citations by year
- 2026: 11 · 2025: 17 · 2024: 5 · 2023: 15 · 2022: 11 · 2021: 17 · 2020: 12 · 2019: 7 · 2018: 14 · 2017: 10 · 2016: 4
- FWCI
- 8.09
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by-nc-nd)
- Figshare (submittedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by-nc-nd)
- Open Research Exeter (University of Exeter) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- University Hospitals of Leicester NHS Trust
- National Institute for Health and Care Research (CL-2013-11-001, RP-PG-0606-1272, NF-SI-0512-10159, CDF-2012-05-259)
- University of Leicester
- Loughborough University
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- type 2 diabetes prevention, prediabetes, primary prevention, lifestyle intervention, structured education programme, behavior change, HbA1c, LDL cholesterol, sedentary behavior, physical activity, general practice, community-based prevention
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 2, Female, United Kingdom, Health Promotion, Humans, Life Style, Male, Mass Screening, Middle Aged, Prediabetic State, Primary Prevention, Program Evaluation, Risk Reduction Behavior, Independent Living
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