Combined Diet and Physical Activity Promotion Programs to Prevent Type 2 Diabetes Among People at Increased Risk: A Systematic Review for the Community Preventive Services Task Force

Details

• Alternative Title:
  Ann Intern Med
• Personal Author:
  Balk, Ethan M. ; Earley, Amy ; Raman, Gowri ; Avendano, Esther A. ; Pittas, Anastassios G. ; Remington, Patrick L.
• Description:
  Background ; Trials have demonstrated the efficacy of rigorous diet and physical activity promotion (D&PA) programs for adults at increased risk for type 2 diabetes to reduce diabetes incidence and improve measures of glycemia. ; Purpose ; To evaluate D&PA programs for individuals at increased risk for type 2 diabetes primarily to lower diabetes risk, lower body weight, and improve glycemia. ; Data Sources ; MEDLINE, Cochrane Central Register of Controlled Trials, CAB Abstracts, Global Health, and Ovid HealthStar from 1991 through 27 February 2015, with no language restriction. ; Study Selection ; 8 researchers screened articles for single group or comparative studies of combined D&PA programs with at least 2 sessions of at least 3 month duration in participants at increased risk for type 2 diabetes. ; Data Extraction ; 7 researchers extracted data-on study design, participant, intervention, outcome descriptions, and results-and assessed study quality. ; Data Synthesis ; 53 studies (30 D&PA vs. control, 13 more vs. less intensive, 13 in single programs) evaluated 66 programs. Compared with usual care, D&PA reduced type 2 diabetes incidence (RR = 0.59; 95% CI 0.51, 0.66; 16 studies), lowered body weight (net change = −2.2%; 95% CI −2.9, −1.4; 24 studies) and fasting blood glucose (net change = −0.12 mmol/L; 95% CI −0.20, −0.05; 17 studies), and improved other cardiometabolic risk factors. There was limited evidence for clinical events. More intensive programs were more effective. ; Limitations ; The wide variation in D&PA programs limited identification of features most relevant to effectiveness. Evidence on clinical outcomes and in children was sparse. ; Conclusions ; Combined D&PA promotion programs are effective to decrease diabetes incidence and improve cardiometabolic risk factors for patients at increased risk. More intensive programs are more effective. ; Primary Funding Source ; Centers for Disease Control and Prevention Community Preventive Services Task Force.
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• Subjects:
  • Blood Glucose
  • Blood Pressure
  • Diabetes Mellitus, Type 2
  • Diet, Reducing
  • Exercise
  • Health Promotion
  • Humans
  • Lipids
  • Risk Factors
  • Weight Loss
• Keywords:
  • pre-diabetes
  • type 2 diabetes
  • diet
  • exercise
  • primary prevention
• Source:
  Ann Intern Med. 163(6):437-451
• Pubmed ID:
  26167912
• Pubmed Central ID:
  PMC4692590
• Document Type:
  Text
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; U01 DK098245/DK/NIDDK NIH HHSUnited States/
• Genre:
  Journal Article
• Volume:
  163
• Issue:
  6
• Download URL:
  https://stacks.cdc.gov/view/cdc/37112/cdc_37112_DS1.pdf
• File Type:
  [PDF - 658.76 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d0b3d90f6cc0807ce5900b3047034a68d7700acc90cda878e0e1ad4c080fee1d589f6103ae317ce5ef751106dfd48b76ba48723b59787cc65f71397863579516