An outpatient-based clinical program for diabetes prevention: an update

Area of Science:

• Clinical Medicine
• Metabolic Disorders
• Public Health Interventions

Background:

• Diabetes prevention programs are crucial for managing rising T2DM rates.
• The Diet-Exercise-Activity-Lifestyle (DEAL) program is a clinic-based intervention targeting individuals at risk for diabetes.
• Understanding the long-term outcomes of such interventions is essential for optimizing patient care.

Purpose of the Study:

• To update and evaluate the outcomes of the Diet-Exercise-Activity-Lifestyle (DEAL) program.
• To assess the effectiveness of the DEAL program in improving key metabolic markers and weight in participants.
• To identify potential factors influencing treatment response within the program.

Main Methods:

• A cohort of 221 participants enrolled in the DEAL program between January 2007 and August 2009 were analyzed.
• Changes in weight, fasting blood glucose, and 2-hour glucose levels post-oral glucose tolerance test were measured.
• Follow-up assessments were conducted at 6 and 12 months post-intervention.

Main Results:

• At 6 months, 59-61% of participants showed improvements in glucose levels and weight; however, nearly 40% were non-responders with increased metrics.
• By 12 months, significant declines in fasting glucose, 2-hour glucose, and weight were observed compared to baseline (P<.001).
• No significant changes in these measures were noted between the 6- and 12-month visits, indicating sustained effects or plateau.

Conclusions:

• The DEAL program demonstrates efficacy in improving glucose control and weight for a majority of participants.
• A significant proportion of patients did not respond or showed worsening glucose intolerance, highlighting a need for personalized approaches.
• Further research is required to identify non-responders' characteristics and refine the DEAL program for universal benefit.