title: The Healthy Living Partnerships to Prevent Diabetes study: 2-year outcomes of a randomized controlled trial.
abstract: BACKGROUND
  Since the Diabetes Prevention Project (DPP) demonstrated that lifestyle weight-loss interventions can reduce the incidence of diabetes by 58%, several studies have translated the DPP methods to public health-friendly contexts. Although these studies have demonstrated short-term effects, no study to date has examined the impact of a translated DPP intervention on blood glucose and adiposity beyond 12 months of follow-up.
  
  
  OBJECTIVE
  To examine the impact of a 24-month, community-based diabetes prevention program on fasting blood glucose, insulin, insulin resistance as well as body weight, waist circumference, and BMI in the second year of follow-up.
  
  
  METHODS
  An RCT comparing a 24-month lifestyle weight-loss program (LWL) to an enhanced usual care condition (UCC) in participants with prediabetes (fasting blood glucose=95-125 mg/dL). Data were collected in 2007-2011; analyses were conducted in 2011-2012.
  
  
  METHODS
  301 participants with prediabetes were randomized; 261 completed the study. The intervention was held in community-based sites.
  
  
  METHODS
  The LWL program was led by community health workers and sought to induce 7% weight loss at 6 months that would be maintained over time through decreased caloric intake and increased physical activity. The UCC received two visits with a registered dietitian and a monthly newsletter.
  
  
  METHODS
  The main measures were fasting blood glucose, insulin, insulin resistance, body weight, waist circumference, and BMI.
  
  
  RESULTS
  Intent-to-treat analyses of between-group differences in the average of 18- and 24-month measures of outcomes (controlling for baseline values) revealed that the LWL participants experienced greater decreases in fasting glucose (-4.35 mg/dL); insulin (-3.01 μU/ml); insulin resistance (-0.97); body weight (-4.19 kg); waist circumference (-3.23 cm); and BMI (-1.40), all p-values <0.01.
  
  
  CONCLUSIONS
  A diabetes prevention program administered through an existing community-based system and delivered by community health workers is effective at inducing significant long-term reductions in metabolic indicators and adiposity.
authors.affiliation: Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina 27109, USA. katulaj@wfu.edu
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Katula
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Morgan
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lawlor
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Blackwell
authors.forename: Scott P
authors.initials: SP
authors.lastname: Isom
authors.forename: Carolyn F
authors.initials: CF
authors.lastname: Pedley
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
mesh_terms: D050154:Adiposity; D000368:Aged; D001786:Blood Glucose; D015992:Body Mass Index; D003153:Community Health Services / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods
chemical_list: D001786:Blood Glucose