Pre-diabetics get real health benefits from lifestyle interventions

Thursday, December 27, 2012 by: David Gutierrez, staff writer
Tags: pre-diabetics, lifestyle interventions, exercise

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(NaturalNews) People at high risk of diabetes can significantly improve their health by taking part in simple, self-directed lifestyle change programs, according to a study conducted by researchers at Stanford University, the Palo Alto Medical Foundation Research Institute, and published in the Archives of Internal Medicine.

This means that the type intervention previously reserved for people who could afford one-on-one, coach-based programs could now be made accessible to the wider public. This would be a boon not just to patients, but also to overworked primary care doctors, who often do not have time to give patients the individualized care that would be most helpful to them.

Diabetes is considered a major public health problem in the United States. It currently affects 8.3 percent of the population - 25.8 million people - and is one of the main causes of heart disease, stroke, kidney failure, adult blindness and non-traumatic amputation of lower limbs. In 2007, national diabetes-related expenses totaled approximately $174 billion.

"Diabetes is an expensive disease to treat and its complications are both personally devastating and societally costly," lead researcher Randall Stafford said.

As a result, effective, low-cost, ways to reduce diabetes prevalence are a major public health concern. In 2002, the Diabetes Prevention Program (DPP) study found that among people at high risk of diabetes (pre-diabetic) received one-on-one coaching for weight loss and exercise, the rate of diabetes was 58 percent less than expected - a better result than that delivered by any pharmaceutical intervention.

Making use of digital technology

In the new study, researchers sought to determine whether the DPP strategy could be adapted to a less individualized format.

"The big issue in diabetes prevention is how to take what clearly worked for DPP - which was very intensive and one-on-one focused - and get it to the point where it could be established as a program in large group practices," Stafford said.

Participants were recruited from among pre-diabetic patients at the Palo Alto Medical Foundation. They were randomly assigned to take part in either a coach-led (DPP-style) intervention, a self-directed (DVD-based) intervention or to receive standard care (no intervention). Both intervention groups involved practical advice on how to eat better and exercise more, as well as information on strategies to help maintain those habits over the long term.

After three months, participants in either of the intervention groups were transitioned into receiving regular emails encouraging them to keep up their new habits. Participants were also directed to use the American Heart Association's Heart360 website to actively monitor their health. This secondary phase lasted 12 months.

The researchers found that while the self-directed intervention was slightly less effective than the coach-led one, both interventions led to significant improvements in body mass index, waist circumference and weight when compared with the control group.

Because nearly all the study participants were white, college-educated and earned more than $75,000 per year, the researchers are now working on replicating the study with a group of low-income Latino participants.


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