title: A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes.
abstract: OBJECTIVE
  To compare the effectiveness and cost of two lifestyle-modification programmes in individuals at high risk of developing type 2 diabetes.
  
  
  METHODS
  Forty-eight men and women with a body mass index ≥27 kg/m(2) and prediabetes were randomly assigned to either a 1-year interdisciplinary intervention including individual counseling every 6 weeks and 25 group seminars (group I; n=22) or a group intervention comprising seminars only (group G; n=26). These interventions were compared in terms of weight loss and improvement of anthropometric measures, metabolic variables and costs.
  
  
  RESULTS
  Participants in group I lost an average of 4.9 kg (95% CI: -7.3, -2.4; P<0.01) and 5 cm in waist circumference (95% CI: -7.0, -3.0; P<0.01), whereas no significant change was noted in those assigned to group G. Among the participants in group I, 50 and 27% lost at least 5 and 10% of their initial weight, respectively, compared with only 12 and 4%, respectively, in group G. Fasting glucose, 2-hour glucose and lipid profiles improved significantly in group I, and no participant (zero on 22) developed diabetes compared with 11.5% (3/26) in group G. Most participants (nine on 11) with impaired fasting glucose in group I returned to normal. The direct cost of the individual intervention was estimated to be $733.06/year per subject compared with $81.36/year per subject for the group intervention.
  
  
  CONCLUSIONS
  This study demonstrates that a low-cost, moderate-intensity, individual interdisciplinary approach combined with group seminars leads to clinically significant weight loss and metabolic improvement in people with prediabetes. Group seminars alone were not effective in this population (www.ClinicalTrial.gov, Identifier: NCT00991549).
authors.affiliation: Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Centre de Recherche Clinique Étienne-LeBel, Sherbrooke, Qc J1H 5N4 Quebec, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Gagnon
authors.forename: C
authors.initials: C
authors.lastname: Brown
authors.forename: C
authors.initials: C
authors.lastname: Couture
authors.forename: C N
authors.initials: CN
authors.lastname: Kamga-Ngande
authors.forename: M F
authors.initials: MF
authors.lastname: Hivert
authors.forename: J P
authors.initials: JP
authors.lastname: Baillargeon
authors.forename: A C
authors.initials: AC
authors.lastname: Carpentier
authors.forename: M F
authors.initials: MF
authors.lastname: Langlois
mesh_terms: D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D005260:Female; D018149:Glucose Intolerance / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D010348:Patient Care Team / Q000191:economics / Q000458:organization & administration*; D011236:Prediabetic State / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D015397:Program Evaluation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss