TY - JOUR
T1 - Challenges of diabetes prevention in the real world
T2 - Results and lessons from the melbourne diabetes prevention study
AU - Dunbar, James A.
AU - Hernan, Andrea L.
AU - Janus, Edward D.
AU - Vartiainen, Erkki
AU - Laatikainen, Tiina
AU - Versace, Vincent L.
AU - Reynolds, John
AU - Best, James D.
AU - Skinner, Timothy C.
AU - O’Reilly, Sharleen L.
AU - Namara, Kevin P.Mc
AU - Stewart, Elizabeth
AU - Coates, Michael
AU - Bennett, Catherine M.
AU - Carter, Rob
AU - Melbourne Diabetes Prevention Study (MDPS)
PY - 2015/3/10
Y1 - 2015/3/10
N2 - Objective: To assess effectiveness and implementability of the public health programme Life! Taking action on diabetes in Australian people at risk of developing type 2 diabetes. Research design and methods: Melbourne Diabetes Prevention Study (MDPS) was a unique study assessing effectiveness of Life! that used a randomized controlled trial design. Intervention participants with AUSDRISK score ≥15 received 1 individual and 5 structured 90 min group sessions. Controls received usual care. Outcome measures were obtained for all participants at baseline and 12 months and, additionally, for intervention participants at 3 months. Per protocol set (PPS) and intention to treat (ITT) analyses were performed. Results: PPS analyses were considered more informative from our study. In PPS analyses, intervention participants significantly improved in weight (−1.13 kg, p=0.016), waist circumference (−1.35 cm, p=0.044), systolic (−5.2 mm Hg, p=0.028) and diastolic blood pressure (−3.2 mm Hg, p=0.030) compared with controls. Based on observed weight change, estimated risk of developing diabetes reduced by 9.6% in the intervention and increased by 3.3% in control participants. Absolute 5-year cardiovascular disease (CVD) risk reduced significantly for intervention participants by 0.97 percentage points from 9.35% (10.4% relative risk reduction). In control participants, the risk increased by 0.11 percentage points (1.3% relative risk increase). The net effect for the change in CVD risk was −1.08 percentage points of absolute risk ( p=0.013). Conclusions: MDPS effectively reduced the risk of diabetes and CVD, but the intervention effect on weight and waist reduction was modest due to the challenges in recruiting high-risk individuals and the abbreviated intervention.
AB - Objective: To assess effectiveness and implementability of the public health programme Life! Taking action on diabetes in Australian people at risk of developing type 2 diabetes. Research design and methods: Melbourne Diabetes Prevention Study (MDPS) was a unique study assessing effectiveness of Life! that used a randomized controlled trial design. Intervention participants with AUSDRISK score ≥15 received 1 individual and 5 structured 90 min group sessions. Controls received usual care. Outcome measures were obtained for all participants at baseline and 12 months and, additionally, for intervention participants at 3 months. Per protocol set (PPS) and intention to treat (ITT) analyses were performed. Results: PPS analyses were considered more informative from our study. In PPS analyses, intervention participants significantly improved in weight (−1.13 kg, p=0.016), waist circumference (−1.35 cm, p=0.044), systolic (−5.2 mm Hg, p=0.028) and diastolic blood pressure (−3.2 mm Hg, p=0.030) compared with controls. Based on observed weight change, estimated risk of developing diabetes reduced by 9.6% in the intervention and increased by 3.3% in control participants. Absolute 5-year cardiovascular disease (CVD) risk reduced significantly for intervention participants by 0.97 percentage points from 9.35% (10.4% relative risk reduction). In control participants, the risk increased by 0.11 percentage points (1.3% relative risk increase). The net effect for the change in CVD risk was −1.08 percentage points of absolute risk ( p=0.013). Conclusions: MDPS effectively reduced the risk of diabetes and CVD, but the intervention effect on weight and waist reduction was modest due to the challenges in recruiting high-risk individuals and the abbreviated intervention.
UR - http://www.scopus.com/inward/record.url?scp=84991265859&partnerID=8YFLogxK
U2 - 10.1136/bmjdrc-2015-000131
DO - 10.1136/bmjdrc-2015-000131
M3 - Journal article
AN - SCOPUS:84991265859
SN - 2052-4897
VL - 3
JO - B M J Open Diabetes Research & Care
JF - B M J Open Diabetes Research & Care
IS - 1
M1 - e000081
ER -
