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DPP-style programs improve cardiometabolic profiles despite alterations
Although often modified from the original, programs based on the Diabetes Prevention Program helped U.S. adults realize weight-loss and cardiometabolic benefits, including reductions in blood glucose, blood pressure and cholesterol levels, according to a meta-analysis.
"This study highlights the advantage of providing a more structured program based on the [Diabetes Prevention Program] for motivated patients." Uma Mudaliar, MD, told Endocrine Today. "Despite the adaptations of the original DPP to various settings, these programs were still effective in reducing weight and improving other cardiovascular risk factors in patients at high risk of diabetes. This shows early promise in the potential of these programs as a useful tool in diabetes prevention."
Mudaliar led a team of researchers at Emory University’s Rollins School of Public Health and the Centers for Disease Control and Prevention, and analyzed data from 44 studies with approximately 9,000 participants at high risk for developing diabetes (25% men; mean age, 50.8 years; mean BMI, 34.8 kg/m2; mean HbA1c, 5.9%; fasting blood glucose, 104.6 mg/dL; blood pressure, 128.7/79.5 mm Hg; HDL 46.1 mg/dL; total cholesterol, 183.7 mg/dL). Mean follow-up was 9.3 months (range, 1.5 to 36 months); 60% of programs offered some form of post-program maintenance.
Across the studies, researchers found reductions in mean weight (-3.77 kg), HbA1c (-0.21%), FBG (-2.4 mg/dL), systolic BP (-4.29 mm Hg), diastolic BP (-2.56 mm Hg) and total cholesterol (-5.34 mg/dL); mean HDL increased by 0.85 mg/dL. Programs with a maintenance component achieved even greater reductions in weight and FBG (an additional -1.66 kg and -3.14 mg/dL, respectively).
“Delivery of lifestyle programs adhering to DPP principles tested in community and clinical settings achieved similar 1-year decreases in weight, FBG and HbA1c as the original DPP study, despite the modifications made to lower cost and improve acceptability across various settings,” researchers wrote. “Though unclear if these changes will translate into reductions in diabetes incidence, prior studies have found decreased incidence to be most closely related to weight loss. Methods to increase uptake and decrease attrition are both needed to enable long-lasting, sustainable lifestyle change in patients with the highest risk of progression to diabetes and its associated complications.”
Researchers noted the heterogeneity of the studies limited the statistical significance of the data.
Disclosure: Researchers report no relevant financial disclosures.