title: A community-based diabetes prevention program: evaluation of the group lifestyle balance program delivered by diabetes educators.
abstract: With growing numbers of people at risk for diabetes and cardiovascular disease, diabetes educators report increasing referrals for intervention in prevention of these conditions. Diabetes educators have expertise in diabetes self-management education; however, they are generally not prepared for delivery of chronic disease primary prevention. The purpose of this project was to determine if individuals at risk for diabetes who participate in an intervention delivered by trained diabetes educators in existing diabetes self-management education community-based programs can reduce risk factors for diabetes and cardiovascular disease.
  
  
  
  Diabetes educators in 3 outpatient-hospital programs (urban, suburban, and rural) received training and support for implementation of the Group Lifestyle Balance program, an adaptation of the Diabetes Prevention Program lifestyle intervention, from the Diabetes Prevention Support Center of the University of Pittsburgh. Adults with prediabetes and/or the metabolic syndrome were eligible to enroll in the program with physician referral. With use of existing diabetes educator networks, recruitment was completed via on-site physician in-services, informative letters, and e-mail contact as well as participant-directed newspaper advertisement.
  
  
  
  Eighty-one participants enrolled in the study (71 women, 10 men). Mean overall weight loss was 11.3 lb (5.1%, P < .001); in addition, significant decreases were noted in fasting plasma glucose, low-density lipoprotein cholesterol, triglycerides, and blood pressure.
  
  
  
  These results suggest that the Group Lifestyle Balance program delivered by diabetes educators was successful in reducing risk for diabetes and cardiovascular disease in high-risk individuals. Furthermore, diabetes educators, already integrated within the existing health care system, provide yet another resource for delivery of primary prevention programs in the community.
authors.affiliation: The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Kramer, Ms Chen)
authors.forename: M Kaye
authors.initials: MK
authors.lastname: Kramer
authors.affiliation: The University of Pittsburgh Medical Center, Pittsburgh,Pennsylvania  (Ms McWilliams)
authors.forename: Janis R
authors.initials: JR
authors.lastname: McWilliams
authors.affiliation: The Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Kramer, Ms Chen)
authors.forename: Hsiang-Yu
authors.initials: HY
authors.lastname: Chen
authors.affiliation: The School of Medicine and Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio)
authors.forename: Linda M
authors.initials: LM
authors.lastname: Siminerio
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005260:Female; D040441:Health Educators / Q000191:economics; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000534:rehabilitation*; D008875:Middle Aged; D009765:Obesity / Q000534:rehabilitation; D010044:Outpatient Clinics, Hospital; D010353:Patient Education as Topic / Q000191:economics / Q000379:methods; D010414:Pennsylvania; D011236:Prediabetic State / Q000534:rehabilitation*; D011446:Prospective Studies; D012648:Self Care; D015431:Weight Loss