title: Can diabetes prevention programmes be translated effectively into real-world settings and still deliver improved outcomes? A synthesis of evidence.
abstract: OBJECTIVE
  Randomized trials provide evidence that intensive lifestyle interventions leading to dietary and physical activity change can delay or prevent Type 2 diabetes. Translational studies have assessed the impact of interventions based on, but less intensive than, trial protocols delivered in community settings with high-risk populations. The aim of this review was to synthesize evidence from translational studies of any design to assess the impact of interventions delivered outside large randomized trials.
  
  
  METHODS
  Medical and scientific databases were searched using specified inclusion and exclusion criteria. Studies were included that used a tested diabetes preventive study protocol with an adult population at risk from Type 2 diabetes. Included papers were quality assessed and data extracted using recommended methods.
  
  
  RESULTS
  From an initial 793 papers, 19 papers reporting 17 studies were included. Translational studies from a range of settings utilized a variety of methods. All were based on the US Diabetes Prevention Programme protocol or the Finnish Diabetes Prevention Study, with modifications that increased feasibility and access. The main outcome that was reported in all studies was weight change. Weight loss, which occurred in all but one study, was greater in intervention arms than in control subjects. No consistent differences were found in blood glucose or waist circumference.
  
  
  CONCLUSIONS
  Translational studies based on the intensive diabetes prevention programmes showed that there is potential for less intensive interventions both to be feasible and to have an impact on future progression to diabetes in at-risk individuals.
authors.affiliation: University of Sheffield, School of Health and Related Research, Sheffield, UK. m.johnson@sheffield.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Johnson
authors.forename: R
authors.initials: R
authors.lastname: Jones
authors.forename: C
authors.initials: C
authors.lastname: Freeman
authors.forename: H B
authors.initials: HB
authors.lastname: Woods
authors.forename: M
authors.initials: M
authors.lastname: Gillett
authors.forename: E
authors.initials: E
authors.lastname: Goyder
authors.forename: N
authors.initials: N
authors.lastname: Payne
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002985:Clinical Protocols; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss