One-Year Results of a Community-Based Translation of the Diabetes Prevention Program Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project
One-Year Results of a Community-Based Translation of the Diabetes Prevention Program Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project
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DOI：
10.2337/dc10-2115
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发表时间：
2011-07-01
期刊：
影响因子：
16.2
通讯作者：
Goff, David C., Jr.
中科院分区：
文献类型：
--
作者：
Katula, Jeffrey A.;Vitolins, Mara Z.;Goff, David C., Jr.
尽管糖尿病预防计划（DPP）和芬兰糖尿病预防研究（FDPS）表明，通过改变生活方式减轻体重可以降低糖尿病前期患者的2型糖尿病发病率，但将其转化为社区环境是困难的。本研究的目的是报告以社区为基础的DPP生活方式减肥（LWL）干预对空腹血糖、胰岛素抵抗研究设计和方法-我们随机分配了301名超重和肥胖的志愿者（BMI 25 - 40 kg/m2），空腹血糖值在95 - 125 mg/dL之间，通过糖尿病教育计划（DEP）实施DPP LWL干预，并由社区卫生工作者（CHW）提供或提供给增强的日常护理条件。CHW是控制良好的2型糖尿病志愿者。共有42.5%的参与者为男性，平均年龄为57.9岁，26%的参与者为白色以外的种族/民族，80%的参与者报告接受过高中以上的教育。主要结果是平均空腹血糖超过12个月的后续行动，调整基线血糖。与普通护理参与者相比，LWL干预参与者经历了血糖显着更大的下降（-4.3 vs.-0.4 mg/dL; P <0.001），胰岛素（-6.5对-2.7 mu U/mL; P <0.001），胰岛素抵抗的稳态模型评估（-1.9 vs.-0.8; P <0.001），体重（-7.1对比-1.4 kg; P <0.001），BMI（-2.1 vs.-0.3 kg/m（2）; P 0.001）和腰围（-5.9 vs.-0.8 cm;结论-在社区环境中进行的DPP干预的这种翻译，通过DEP管理，并由CHW提供，通过显著降低葡萄糖，胰岛素，和肥胖。
OBJECTIVE-Although the Diabetes Prevention Program (DPP) and the Finnish Diabetes Prevention Study (FDPS) demonstrated that weight loss from lifestyle change reduces type 2 diabetes incidence in patients with prediabetes, the translation into community settings has been difficult. The objective of this study is to report the first-year results of a community-based translation of the DPP lifestyle weight loss (LWL) intervention on fasting glucose, insulin resistance, and adiposity.RESEARCH DESIGN AND METHODS-We randomly assigned 301 overweight and obese volunteers (BMI 25-40 kg/m(2)) with fasting blood glucose values between 95 and 125 mg/dL to a group-based translation of the DPP LWL intervention administered through a diabetes education program (DEP) and delivered by community health workers (CHWs) or to an enhanced usual-care condition. CHWs were volunteers with well-controlled type 2 diabetes. A total of 42.5% of participants were male, mean age was 57.9 years, 26% were of a race/ethnicity other than white, and 80% reported having an education beyond high school. The primary outcome is mean fasting glucose over 12 months of follow-up, adjusting for baseline glucose.RESULTS-Compared with usual-care participants, LWL intervention participants experienced significantly greater decreases in blood glucose (-4.3 vs. -0.4 mg/dL; P < 0.001), insulin (-6.5 vs. -2.7 mu U/mL; P < 0.001), homeostasis model assessment of insulin resistance (-1.9 vs. -0.8; P < 0.001), weight (-7.1 vs. -1.4 kg; P < 0.001), BMI (-2.1 vs. -0.3 kg/m(2); P 0.001), and waist circumference (-5.9 vs. -0.8 cm; P < 0.001).CONCLUSIONS-This translation of the DPP intervention conducted in community settings, administered through a DEP, and delivered by CHWs holds great promise for the prevention of diabetes by significantly decreasing glucose, insulin, and adiposity.