The InnvaDiab-DE-PLAN study: a randomised controlled trial with a culturally adapted education programme improved the risk profile for type 2 diabetes in Pakistani immigrant women.
The objective of the present study was to explore whether a culturally adapted lifestyle education programme would improve the risk factor profile for type 2 diabetes (T2D) and the metabolic syndrome (MetS) among Pakistani immigrant women in Oslo, Norway. The randomised controlled trial (the InnvaDiab study), lasting 7 ± 1 months, comprised six educational sessions about blood glucose, physical activity and diet. Participants (age 25-62 years) were randomised into either a control (n 97) or an intervention (n 101) group. Primary outcome variables were fasting and 2 h blood glucose, and secondary outcome variables were fasting levels of insulin, C-peptide, lipids, glycated Hb, BMI, waist circumference and blood pressure, measured 1-3 weeks before and after the intervention. During the intervention period, the mean fasting blood glucose decreased by 0·16 (95 % CI -0·27, -0·05) mmol/l in the intervention group, and remained unchanged in the control group (difference between the groups, P=0·022). Glucose concentration 2 h after the oral glucose tolerance test decreased by 0·53 (95 % CI -0·84, -0·21) mmol/l in the intervention group, but not significantly more than in the control group. A larger reduction in fasting insulin was observed in the intervention group than in the control group (between-group difference, P= 0·036). Among the individuals who attended four or more of the educational sessions (n 59), we found a more pronounced decrease in serum TAG (-0·1 (95 % CI -0·24, 0·07) mmol/l) and BMI (-0·48 (95 % CI -0·78, -0·18) kg/m²) compared with the control group. During the intervention period, there was a significant increase in participants having the MetS in the control group (from 41 to 57 %), which was not seen in the intervention group (from 44 to 42 %). Participation in a culturally adapted education programme may improve risk factors for T2D and prevent the development of the MetS in Pakistani immigrant women.
Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Victoria
V
Telle-Hjellset
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Marte K
MK
Råberg Kjøllesdal
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Benedikte
B
Bjørge
Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Gerd
G
Holmboe-Ottesen
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Margareta
M
Wandel
Department of Endocrinology, Faculty of Medicine, Oslo University Hospital, University of Oslo, Oslo, Norway.
Kåre I
KI
Birkeland
The Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Uni Health, Uni Research, Bergen, Norway.
Hege R
HR
Eriksen
Department of Community Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
Arne Torbjørn
AT
Høstmark
D000328:Adult; D015992:Body Mass Index; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D004032:Diet / Q000009:adverse effects / Q000208:ethnology; D054242:Emigrants and Immigrants; D005260:Female; D006293:Health Promotion; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D006946:Hyperinsulinism / Q000517:prevention & control; D008019:Life Style / Q000208:ethnology; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009043:Motor Activity; D009664:Norway / Q000453:epidemiology; D052756:Nutritional Sciences / Q000193:education; D010154:Pakistan / Q000208:ethnology; D010353:Patient Education as Topic; D057285:Precision Medicine; D012307:Risk Factors; D020377:Self Efficacy; D014504:Urban Health / Q000208:ethnology