title: Does Type 2 Diabetes Genetic Testing and Counseling Reduce Modifiable Risk Factors? A Randomized Controlled Trial of Veterans.
abstract: OBJECTIVE
  We examined the clinical utility of supplementing type 2 diabetes mellitus (DM) risk counseling with DM genetic test results and counseling.
  
  
  METHODS
  In this randomized controlled trial, non-diabetic overweight/obese veteran outpatients aged 21 to 65 years received DM risk estimates for lifetime risk, family history, and fasting plasma glucose, followed by either genetic test results (CR+G; N = 303) or control eye disease counseling (CR+EYE; N = 298). All participants received brief lifestyle counseling encouraging weight loss to reduce the risk of DM.
  
  
  RESULTS
  The mean age was 54 years, 53% of participants were black, and 80% were men. There was no difference between arms in weight (estimated mean difference between CR+G vs. CR+EYE at 3 months = 0.2 kg, 95% CI: -0.3 to 0.7; at 6 months = 0.4 kg, 95 % CI: -0.3 to 1.1), insulin resistance, perceived risk, or physical activity at 3 or 6 months. Calorie and fat intake were lower in the CR+G arm at 3 months (p's ≤ 0.05) but not at 6 months (p's > 0.20).
  
  
  CONCLUSIONS
  Providing patients with genetic test results was not more effective in changing patient behavior to reduce the risk of DM compared to conventional risk counseling.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01060540 http://clinicaltrials.gov/show/NCT01060540.
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. corrine.voils@dm.duke.edu.|Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA. corrine.voils@dm.duke.edu.
authors: Corrine I
authors: CI
authors: Voils
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. cynthia.coffman@duke.edu.|Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA. cynthia.coffman@duke.edu.
authors: Cynthia J
authors: CJ
authors: Coffman
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. janet.grubber@va.gov.
authors: Janet M
authors: JM
authors: Grubber
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. dedelman@duke.edu.|Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA. dedelman@duke.edu.
authors: David
authors: D
authors: Edelman
authors: Department of Medicine, Duke University Medical Center, Campus Box 3709, Durham, NC, 27710, USA. azita.sadeghpour@duke.edu.
authors: Azita
authors: A
authors: Sadeghpour
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. matthew.maciejewski@va.gov.|Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA. matthew.maciejewski@va.gov.
authors: Matthew L
authors: ML
authors: Maciejewski
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. jamiyla.bolton@va.gov.
authors: Jamiyla
authors: J
authors: Bolton
authors: Department of Medicine, Duke University Medical Center, 3100 Tower Blvd, Suite 600, DUMC Box 3329, Durham, NC, 27707, USA. alex.cho@duke.edu.
authors: Alex
authors: A
authors: Cho
authors: Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA. geoffrey.ginsburg@duke.edu.|Center for Personalized and Precision Medicine, 101 Science Dr, Rm 2111, CIEMAS Bldg, Duke Box 3382, Durham, NC, 27708, USA. geoffrey.ginsburg@duke.edu.
authors: Geoffrey S
authors: GS
authors: Ginsburg
authors: Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton St., Durham, NC, 27705, USA. yancy006@mc.duke.edu.|Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA. yancy006@mc.duke.edu.
authors: William S
authors: WS
authors: Yancy
mesh_terms: D000328:Adult; D000368:Aged; D003376:Counseling / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000235:genetics* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005817:Genetic Counseling / Q000379:methods*; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000379:methods*; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009765:Obesity / Q000150:complications / Q000523:psychology; D017063:Outcome Assessment, Health Care / Q000379:methods; D050177:Overweight / Q000150:complications / Q000523:psychology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D014728:Veterans; D015431:Weight Loss; D055815:Young Adult
keywords: Diabetes mellitus; Genetic counseling; Risk factors