title: Effective Translation of an Intensive Lifestyle Intervention for Hispanic Women With Prediabetes in a Community Health Center Setting.
abstract: The Diabetes Prevention Program (DPP) demonstrated that weight loss from intensive lifestyle intervention (ILI) in adults with prediabetes could decrease progression to type 2 diabetes. Inner-city, low-income Hispanic women are at high risk for developing type 2 diabetes; however, this type of intervention is not well established in this group. We hypothesized that a DPP intervention modified for a community health center (CHC) setting would decrease weight and improve metabolic measures in Hispanic women with prediabetes.
  
  
  
  Women diagnosed with prediabetes on a screening oral glucose tolerance test were recruited from a CHC. Participants (90% of whom were Hispanic) were randomized to either usual care (age 43 ± 9.7 years, BMI 35.2 ± 7.3 kg/m(2)) or ILI (age 43.8 ± 10.8 years, BMI 35.4 ± 8.5 kg/m(2)), structured as 14 weeks of group sessions focused on food choices, behavior change, physical activity, and weight loss. One year after enrollment, 122 women repeated baseline measures.
  
  
  
  Groups had similar baseline weight, BMI, and fasting and 2-h glucose. One year later, the ILI group had lost 3.8 kg (4.4%), while the usual care group had gained 1.4 kg (1.6%, P < 0.0001). Two-hour glucose excursion decreased 15 mg/dL (0.85 mmol/L) in the ILI and 1 mg/dL (0.07 mmol/L) in the usual care group (P = 0.03). Significant decreases favoring the ILI group were noted in BMI, percent body fat, waist circumference, and fasting insulin.
  
  
  
  A 14-week ILI program based on the DPP can effectively be translated into a predominantly Hispanic CHC setting, resulting in decreased weight, improved fasting insulin, and smaller glucose excursions 1 year after enrolling in the program.
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Van Name
authors.affiliation: Fair Haven Community Health Center, New Haven, CT a.camp@fhchc.org.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Camp
authors.affiliation: Fair Haven Community Health Center, New Haven, CT.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Magenheimer
authors.affiliation: Yale School of Public Health, Yale University, New Haven, CT.
authors.forename: Fangyong
authors.initials: F
authors.lastname: Li
authors.affiliation: Yale School of Public Health, Yale University, New Haven, CT.
authors.forename: James D
authors.initials: JD
authors.lastname: Dziura
authors.affiliation: Fair Haven Community Health Center, New Haven, CT.
authors.forename: Abmaridel
authors.initials: A
authors.lastname: Montosa
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: Anisha
authors.initials: A
authors.lastname: Patel
authors.affiliation: Division of Pediatric Endocrinology, Department of Pediatrics, Yale University School of Medicine, New Haven, CT.
authors.forename: William V
authors.initials: WV
authors.lastname: Tamborlane
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002755:Choice Behavior; D003151:Community Health Centers; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000517:prevention & control; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D005518:Food Preferences; D006630:Hispanic or Latino; D006801:Humans; D007328:Insulin / Q000097:blood; D008019:Life Style; D008875:Middle Aged; D010865:Pilot Projects; D011236:Prediabetic State / Q000208:ethnology / Q000628:therapy*; D012307:Risk Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference; D015431:Weight Loss; D055815:Young Adult
chemical_list: D007328:Insulin