Cardiometabolic Risk Factor Changes Observed in Diabetes Prevention Programs in US Settings: A Systematic Review and Meta-analysis

Details

• Alternative Title:
  PLoS Med
• Personal Author:
  Mudaliar, Uma ; Zabetian, Azadeh ; Goodman, Michael ; Echouffo-Tcheugui, Justin B. ; Albright, Ann L. ; Gregg, Edward W. ; Ali, Mohammed K.
• Description:
  Background
  
  The Diabetes Prevention Program (DPP) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk. No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in nonresearch settings in the United States.
  
  Methods and Findings
  
  In this systematic review and meta-analysis, we pooled data from studies in the United States implementing DPP lifestyle modification programs (focused on modest [5%–7%] weight loss through ≥150 min of moderate physical activity per week and restriction of fat intake) in clinical, community, and online settings. We reported aggregated pre- and post-intervention weight and cardiometabolic risk factor changes (fasting blood glucose [FBG], glycosylated hemoglobin [HbA1c], systolic or diastolic blood pressure [SBP/DBP], total [TC] or HDL-cholesterol). We searched the MEDLINE, EMBASE, Cochrane Library, and Clinicaltrials.gov databases from January 1, 2003, to May 1, 2016. Two reviewers independently evaluated article eligibility and extracted data on study designs, populations enrolled, intervention program characteristics (duration, number of core and maintenance sessions), and outcomes. We used a random effects model to calculate summary estimates for each outcome and associated 95% confidence intervals (CI). To examine sources of heterogeneity, results were stratified according to the presence of maintenance sessions, risk level of participants (prediabetes or other), and intervention delivery personnel (lay or professional).
  
  Conclusions
  
  DPP lifestyle modification programs achieved clinically meaningful weight and cardiometabolic health improvements. Together, these data suggest that additional value is gained from these programs, reinforcing that they are likely very cost-effective.
  
  Why Was This Study Done?
  
  What Did the Researchers Do and Find?
  
  What Do These Findings Mean?
  
  
• Subjects:
  Cardiovascular Diseases Diabetes Mellitus, Type 2 Female Humans Male Middle Aged Risk Factors Risk Reduction Behavior Treatment Outcome
• Source:
  PLoS Med. 13(7).
• Pubmed ID:
  27459705
• Pubmed Central ID:
  PMC4961455
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Volume:
  13
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0a6679b5bb1614022c84e5d3e9843fcf18833a085bb3d85e0bb8e039c5b55045
• Download URL:
  https://stacks.cdc.gov/view/cdc/41507/cdc_41507_DS1.pdf
• File Type:
  [PDF - 1.31 MB ]