One-Year Results of a Community-Based Translation of the Diabetes Prevention Program
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OBJECTIVE: Although the Diabetes Prevention Program (DPP) and the Finnish Diabetes Prevention Study (FDPS) demonstrated that weight loss from lifestyle change reduces type 2 diabetes incidence in patients with prediabetes, the translation into community settings has been difficult. The objective of this study is to report the first-year results of a community-based translation of the DPP lifestyle weight loss (LWL) intervention on fasting glucose, insulin resistance, and adiposity. RESEARCH DESIGN AND METHODS: We randomly assigned 301 overweight and obese volunteers (BMI 25–40 kg/m2) with fasting blood glucose values between 95 and 125 mg/dL to a group-based translation of the DPP LWL intervention administered through a diabetes education program (DEP) and delivered by community health workers (CHWs) or to an enhanced usual-care condition. CHWs were volunteers with well-controlled type 2 diabetes. A total of 42.5% of participants were male, mean age was 57.9 years, 26% were of a race/ethnicity other than white, and 80% reported having an education beyond high school. The primary outcome is mean fasting glucose over 12 months of follow-up, adjusting for baseline glucose. RESULTS: Compared with usual-care participants, LWL intervention participants experienced significantly greater decreases in blood glucose (−4.3 vs. −0.4 mg/dL; P < 0.001), insulin (−6.5 vs. −2.7 μU/mL; P < 0.001), homeostasis model assessment of insulin resistance (−1.9 vs. −0.8; P < 0.001), weight (−7.1 vs. −1.4 kg; P < 0.001), BMI (−2.1 vs. −0.3 kg/m2; P < 0.001), and waist circumference (−5.9 vs. −0.8 cm; P < 0.001). CONCLUSIONS: This translation of the DPP intervention conducted in community settings, administered through a DEP, and delivered by CHWs holds great promise for the prevention of diabetes by significantly decreasing glucose, insulin, and adiposity.
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Tobacco quit lines, YMCA-based Diabetes Prevention Program treatment, and peer educator-led Diabetes Prevention Program treatment are all examples of effective programs that were originally developed by behavior change professionals and then effectively implemented in the community.
“Tobacco quit lines,74 YMCA-based Diabetes Prevention Program treatment,60 and peer educator–led Diabetes Prevention Program treatment59 are all examples of effective programs that were originally developed by behavior change professionals and then effectively implemented in the community.”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [59]
The addition of allied health experts to the interprofessional healthcare team either by physical colocation, distance consultation, or engagement in staff training can help to achieve higher-quality, more cost-effective care.
“The addition of these experts to the interprofessional healthcare team either by physical colocation, distance consultation, or engagement in staff training can help to achieve higher-quality, more cost-effective care.57–63”
From Better Population Health Through Behavior Change in Adults: A Call to Action (2013) · cites this paper as [59]
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- Authors
- Katula, J. A., Vitolins, M. Z., Rosenberger, E. L., Blackwell, C. S., Morgan, T. M., Lawlor, M. S., & Goff, D. C.
- Affiliations
- Wake Forest University (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Katula, Jeffrey A.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-06-17
- Volume
- 34
- Issue
- 7
- Pages
- 1451-1457
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3120203
- OpenAlex
- W1980078112
- Cited by
- 218
- References
- 30
- Citations by year
- 2025: 4 · 2024: 4 · 2023: 6 · 2022: 9 · 2021: 11 · 2020: 14 · 2019: 13 · 2018: 16 · 2017: 16 · 2016: 18 · 2015: 26 · 2014: 30 · 2013: 26 · 2012: 19
- FWCI
- 21.23
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R18DK069901)
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- Diabetes Prevention Program, prediabetes, type 2 diabetes prevention, community-based intervention, community health workers, diabetes education program, fasting blood glucose, insulin resistance, adiposity, weight loss, overweight and obesity
- MeSH terms
- Aged, Blood Glucose, Community Health Workers, Diabetes Mellitus, Type 2, Female, Health Promotion, Humans, Insulin Resistance, Life Style, Male, Middle Aged, Obesity, Patient Education as Topic, Prediabetic State, Weight Loss
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