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Community-based diabetes prevention program appears to reduce CHD risk in overweight adults with prediabetes
Wednesday, March 25 2009 | Comments
What's This?
Community-based delivery of a diabetes prevention program is associated with significant reductions in 10-year coronary heart disease (CHD) risk for overweight adults with prediabetes, according to findings from the DEPLOY study. In the trial, researchers randomized YMCA facilities to receive training and support for delivering a formal, group-based adaptation of the Diabetes Prevention Program lifestyle intervention or a control condition in which facilities provided information only about existing YMCA wellness programs; 92 overweight adults with prediabetes participated in the trial. The investigators used the U.K. Prospective Diabetes Study risk engine to estimate the 10-year risk of CHD for the participants at baseline and after 4 and 12 months.
After 4 months, the 10-year risk of CHD had decreased 3.28% among the individuals who received the lifestyle intervention and 0.78% among the controls. From months 4 to 12, the risk of CHD increased in the intervention group but did not return to baseline levels (-2.23% relative to baseline). By contrast, among the controls, the risk of CHD had increased 1.88% relative to baseline. The difference between the 2 groups was statistically significant at both time points (month 4, P=.028; month 12, P=.007) and increased from month 4 to month 12.
Secondary analyses of changes in individual risk factors suggested that much of the between-group difference in predicted CHD risk was the result of changes in the total:high-density lipoprotein cholesterol ratio.
Although the authors acknowledged several limitations to their study, including an overall dropout rate of approximately 33%, they suggested that community-based delivery of the lifestyle intervention "could be a promising strategy to prevent both CHD and type 2 diabetes in adults with prediabetes." (Lipscomb ER, et al. Diabetes Care 2009;32:394-396.)
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