Diabetes prevention program in a Mediterranean environment: individual or group therapy? An effectiveness evaluation

Area of Science:

• Public Health
• Preventive Medicine
• Endocrinology

Background:

• Type 2 diabetes is a multifactorial disorder requiring simultaneous risk factor modification for effective prevention.
• The American Diabetes Prevention Program (DPP) demonstrated success, inspiring similar interventions.
• This study implemented a Mediterranean Diet (MedDiet) and physical activity intervention in an Israeli healthcare setting.

Purpose of the Study:

• To evaluate the effectiveness of individual versus group therapy interventions.
• To assess the impact on reducing diabetes risk factors.
• To determine the prevention or delay of type 2 diabetes development.

Main Methods:

• 85 physicians referred pre-diabetes patients to either individual or group therapy (111 and 112 patients, respectively).
• Intervention focused on MedDiet benefits, nutritional behavior, mindful eating, and physical activity over 6 months.
• A 24-month follow-up utilized logistic, mixed models, and Cox regressions.

Main Results:

• No significant differences in age, gender, or clinical measurements between groups at baseline.
• 39% of patients in both individual and group therapy developed diabetes (entered the Diabetes Registry).
• Mean time to diabetes registry entry was similar: 2.9 years (individual) vs. 2.5 years (group).

Conclusions:

• Both individual and group interventions demonstrated equal effectiveness in achieving desired outcomes and delaying diabetes onset.
• Group therapy is recommended for large healthcare organizations with high pre-diabetes populations and limited resources due to its cost-effectiveness.
• Group therapy allows one team member to reach 12 patients, optimizing resource allocation.