Adults with prediabetes assigned to a fully automated diabetes prevention program for 6 months showed improvements in physical activity and dietary variables vs. a control group assigned to a wait list, according to findings from a randomized controlled trial.
“This study showed that this email- and web-based intervention helped people to make the eating and physical activity behavior changes that can help prevent progression to diabetes,” Gladys Block, PhD, scientific director of Turnaround Health in Berkeley, California, told Endocrine Today. “These behavioral changes paralleled the significant impact of the program in lowering HbA1c, fasting glucose, weight, metabolic syndrome and other factors that were reported in an earlier paper.”
Block and colleagues analyzed data from 339 adults with prediabetes (mean age, 55 years; 69% men; 68.1% with metabolic syndrome) who were randomly assigned to immediately begin the Alive-PD program, a 1-year intervention designed to prevent the development of type 2 diabetes (n = 163) or to begin the program after 6 months (controls; n = 176). Within the cohort, 95% had prediabetes confirmed by fasting glucose measurement; 45% had prediabetes confirmed by HbA1c.
At baseline, participants reported engaging in leisure-time aerobic activity for a mean of 2.29 days per week and reported eating fruits and vegetables 1.28 times per day (about nine times per week). At 6 months, both groups changed behaviors in physical activity and dietary choices, reporting decreases in the intake of bread, pasta/white rice and sweets, as well as red meat.
However, effect sizes for changes in fruit and combined fruit and vegetable were 0.58 and 0.62, respectively. Effect sizes for aerobic activity, refined carbohydrates, sweets and vegetables ranged from 0.34 to 0.49.
With the exception of red meat, researchers observed differences between the intervention group and controls in intention-to-treat analysis, researchers wrote.
“Changes in eating and activity behaviors are what we hope for, both in diabetes prevention and diabetes management,” Block said. “Such changes are not always achieved, yet are key for long-term effectiveness. This program adds a tool that can help.
“The small number of individuals in the trial who were in the diabetic range by fasting glucose all reduced their fasting glucose to either the pre-diabetic or the normal range,” Block said.
“We would like to be able to test the program in a population with type 2 diabetes, to support the efforts of diabetes educators and endocrinologists to help patients improve their eating and activity behaviors,” she said. – by Regina Schaffer
Disclosure: Block and two other researchers are co-owners of Turnaround Health, which developed Alive-PD.