Researchers say that lifestyle changes play a key role in preventing diabetes.
Researchers from Emory's Rollins School of Public Health (RSPH) systematically reviewed the published literature and analyzed 28 studies that tested adaptations of the Diabetes Prevention Program (DPP) trial in real-world settings.
Published in 2002, this major clinical trial showed that structured lifestyle programs for people with prediabetes could halve the progression to diabetes.
"Participants in the DPP trial received exercise shoes, meal replacement shakes, personal (one-on-one) coaching by degree-holding professionals (exercise physiologists, nutritionists, nurses), and gym memberships that all together cost about 1,400 dollars per person during the first year of the study," said lead investigator Mohammed Ali, MBChB, MSc, assistant professor of global health at Emory's RSPH.
"Over the years, a number of studies have tried to adapt the program and make it more affordable. My colleagues and I scanned the literature to find all such studies in the US, and combined the data to see what kind of average weight loss benefit is possible across all of these studies as moderate (5-7 percent) weight loss was the key driver of success in the DPP trial."
The researchers found that a year after enrollment in these lifestyle programs, the average participant had lost about four percent of baseline body weight, an amount that may offer diabetes protection.
The weight loss was the same regardless of whether the program relied on higher-salaried health professionals or lower-cost lay staff who are trained to deliver healthy eating and fitness advice.
The authors concluded that costs associated with diabetes prevention can be lowered without sacrificing effectiveness and that motivating higher session attendance in structured programs seemed to be the key driver of success in achieving weight loss.
The study has been recently published in Health Affairs.