title: One-year results of a community-based translation of the Diabetes Prevention Program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project.
abstract: 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.
  
  
  METHODS
  We randomly assigned 301 overweight and obese volunteers (BMI 25-40 kg/m(2)) 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.
authors: Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA. katulaj@wfu.edu
authors: Jeffrey A
authors: JA
authors: Katula
authors: Mara Z
authors: MZ
authors: Vitolins
authors: Erica L
authors: EL
authors: Rosenberger
authors: Caroline S
authors: CS
authors: Blackwell
authors: Timothy M
authors: TM
authors: Morgan
authors: Michael S
authors: MS
authors: Lawlor
authors: David C
authors: DC
authors: Goff
references: J Public Health Manag Pract. 2008 Jan-Feb;14(1):29-32
references: 18091037
references: Diabetes Care. 2010 Oct;33(10):2146-51
references: 20664020
references: Surg Obes Relat Dis. 2008 Sep-Oct;4(5 Suppl):S109-84
references: 18848315
references: Am J Prev Med. 2005 Jan;28(1):126-39
references: 15626569
references: Contemp Clin Trials. 2010 Jan;31(1):71-81
references: 19758580
references: Am J Hum Biol. 1993;5(2):159-167
references: 28524338
references: Diabet Med. 2006 May;23(5):544-56
references: 16681564
references: N Engl J Med. 2006 Oct 12;355(15):1563-71
references: 17035649
references: Diabetes Care. 2006 Jun;29(6):1263-8
references: 16732006
references: Am J Prev Med. 2008 Oct;35(4):357-63
references: 18779029
references: Nature. 2006 Dec 14;444(7121):840-6
references: 17167471
references: Diabetes Educ. 2009 Mar-Apr;35(2):199-204, 208
references: 19321806
references: N Engl J Med. 2002 Feb 7;346(6):393-403
references: 11832527
references: Diabetologia. 1985 Jul;28(7):412-9
references: 3899825
references: Diabetes Care. 2001 Feb;24(2):362-5
references: 11213893
references: Am J Prev Med. 2009 Dec;37(6):505-11
references: 19944916
references: J Nutr Health Aging. 2008 Dec;12(10):745S-749S
references: 19043651
references: Diabetes Educ. 2009 Mar-Apr;35(2):209-10, 213-4, 216-20 passim
references: 19321807
references: Contemp Clin Trials. 2011 Jan;32(1):40-9
references: 20974289
references: Diabetes Care. 2007 Oct;30(10):2465-70
references: 17586741
references: N Engl J Med. 2001 May 3;344(18):1343-50
references: 11333990
references: Diabetes Care. 2004 Jan;27 Suppl 1:S5-S10
references: 14693921
references: Nurs Res. 2009 Jan-Feb;58(1):2-12
references: 19092550
references: Arch Intern Med. 2008 Jan 28;168(2):192-9; discussion 199
references: 18227367
references: Diabetes Care. 2004 Aug;27(8):2067-73
references: 15277443