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A systematic review of the translational research on the Diabetes Prevention Program

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Translational Behavioral Medicine

ABSTRACT

International clinical trials have demonstrated compelling evidence on the prevention or delay of type 2 diabetes (T2D) by lifestyle change programs. Numerous studies have translated the Diabetes Prevention Program (DPP) protocol to “real-world” settings. The purpose of this paper is to review the translational research of the DPP protocol in adults at-risk for T2D. This study is a systematic review based on the guidelines from the Cochrane Handbook for Systematic Reviews. There were 16 studies that translated the DPP protocol in four distinct settings: (a) hospital outpatient, (b) primary care, (c) community, and (d) work and church. Settings varied considerably in terms of reach, efficacy, adoption, implementation, and maintenance. There were strengths and limitations to each setting. Better understanding of program adaptation and mediators and moderators to program efficacy are indicated. Future research also needs to continue to explore mechanisms to improve access and long-term outcomes.

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References

  1. Centers for Disease Control and Prevention (2011) National diabetes fact sheet: National estimates and general information on diabetes and prediabetes in the United States.

  2. Eriksson, K. F., & Lingarde, F. (1991). Prevention of type 2 diabetes mellitus by diet and physical exercise: The 6-year Malmo feasibility study. Diabetologia, 34, 891–898.

    Article  PubMed  CAS  Google Scholar 

  3. Knowler, W. C., Barrett-Connor, E., Fowler, S. E., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346(6), 393–403. doi:10.1056/NEJMoa012512.

    Article  PubMed  CAS  Google Scholar 

  4. Pan, X. R., Li, G. W., Hu, Y. H., et al. (1997). Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care, 20(4), 537–544.

    Article  PubMed  CAS  Google Scholar 

  5. Diabetes Prevention Program Research Group. (2009). 10-Year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet, 14, 1677–1686.

    Article  Google Scholar 

  6. Colman, E., Katzel, L. I., Rogus, E., Coon, P., Muller, D., & Goldberg, A. P. (1995). Weight loss reduces abdominal fat and improves insulin action in middle-aged and older men with impaired glucose tolerance. Metabolism, 44(11), 1502–1508.

    Article  PubMed  CAS  Google Scholar 

  7. Rana, J. S., Li, T. Y., Manson, J. E., & Hu, F. B. (2007). Adiposity compared with physical inactivity and risk of type 2 diabetes in women. Diabetes Care, 30(1), 53–58. doi:10.2337/dc06-1456.

    Article  PubMed  Google Scholar 

  8. American Diabetes Association. (2009). Standards of care in diabetes. Diabetes Care, 32, S1–S61.

    Article  Google Scholar 

  9. Herman, W. H., Hoerger, T. J., Brandle, M., et al. (2005). The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Annals of Internal Medicine, 142(5), 323–332.

    PubMed  Google Scholar 

  10. Diabetes Prevention Research Group. (1999). Design and methods for a clinical trial in the prevention of T2D. Diabetes Care, 22, 623–634.

    Article  Google Scholar 

  11. Hussain, A., Claussen, B., Ramachandran, A., & Williams, R. (2007). Prevention of type 2 diabetes: A review. Diabetes Research and Clinical Practice, 76, 317–326.

    Article  PubMed  CAS  Google Scholar 

  12. Yamaoka, K., & Tango, T. (2005). Efficacy of lifestyle education to prevent type 2 diabetes. Diabetes Care, 28, 2780–2786.

    Article  PubMed  Google Scholar 

  13. Nield, L., Summerbell, C. D., Hooper, L., Whittaker, V., & Moore, H. (2008). Dietary advice for the prevention of type 2 diabetes mellitus in adults. Cochrane Database Systematic Review, 16(3), CD005102.

    Google Scholar 

  14. Orozco, L. J., Buchieitner, A. M., Gimenez-Perez, G., Roque, I., Figuls, M., Richter, B., et al. (2008). Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Systematic Review, 16(3), CD003054.

    Google Scholar 

  15. Satterfield, D. W., Volansky, M., Caspersen, C. J., et al. (2003). Community-based lifestyle interventions to prevent type 2 diabetes. Diabetes Care, 26, 2643–2652.

    Article  PubMed  Google Scholar 

  16. Edwards, K., & Patchell, B. (2009). State of the science: A cultural view of Native Americans and diabetes prevention. Journal of Cultural Diversity, 16(1), 32–35.

    PubMed  Google Scholar 

  17. Jackson, L. (2009). Translating the diabetes prevention program into practice: A review of community interventions. The Diabetes Educator, 35, 309–320.

    Article  PubMed  Google Scholar 

  18. Glasgow, R. E., Vogt, T. M., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322–1327.

    Article  PubMed  CAS  Google Scholar 

  19. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. 2009;Version 5.0.2.

  20. Ackermann, R. T., Finch, E. A., Brizendine, E., Zhou, H., & Marrero, D. G. (2008). Translating the Diabetes Prevention Program into the community. The DEPLOY Pilot Study. American Journal of Preventive Medicine, 35(4), 357–363. doi:10.1016/j.amepre.2008.06.035.

    Article  PubMed  Google Scholar 

  21. Whittemore, R., Melkus, G., Wagner, J., Dziura, J., Northrup, V., & Grey, M. (2009). Translating the diabetes prevention program to primary care: A pilot study. Nursing Research, 58(1), 2–12. doi:10.1097/NNR.0b013e31818fcef3.

    Article  PubMed  Google Scholar 

  22. McTigue, K. M., Conroy, M. B., Bigi, L., Murphy, C., & McNeil, M. (2009). Weight loss through living well: Translating an effective lifestyle intervention into clinical practice. Diabetes Educ, 35(2), 199–204. 208.

    Article  PubMed  Google Scholar 

  23. Vanderwood, K. K., Hall, T. O., Harwell, T. S., Butcher, M. K., & Helgerson, S. D. (2010). Montana Cardiovascular Disease and Diabetes Prevention Program Workgroup. Implementing a state-based cardiovascular disease and diabetes prevention program. Diabetes Care, 33(12), 2543–2545. doi:10.2337/dc10-0862.

    Article  PubMed  Google Scholar 

  24. McBride, P. E., Einerson, J. A., Grant, H., et al. (2008). Putting the Diabetes Prevention Program into practice: A program for weight loss and cardiovascular risk reduction for patients with metabolic syndrome or type 2 diabetes mellitus. The Journal of Nutrition, Health & Aging, 12(10), 745S–749S.

    CAS  Google Scholar 

  25. Pagoto, S. L., Kantor, L., Bodenlos, J. S., Gitkind, M., & Ma, Y. (2008). Translating the diabetes prevention program into a hospital-based weight loss program. Health Psychology, 27(1 Suppl), S91–8. doi:10.1037/0278-6133.27.1.S91.

    Article  PubMed  Google Scholar 

  26. Vadheim, L. M., McPherson, C., Kassner, D. R., et al. (2010). Adapted diabetes prevention program lifestyle intervention can be effectively delivered through telehealth. The Diabetes Educator, 36(4), 651–656. doi:10.1177/0145721710372811.

    Article  PubMed  Google Scholar 

  27. Kramer, M. K., Kriska, A. M., Venditti, E. M., et al. (2009). Translating the Diabetes Prevention Program: A comprehensive model for prevention training and program delivery. American Journal of Preventive Medicine, 37(6), 505–511. doi:10.1016/j.amepre.2009.07.020.

    Article  PubMed  Google Scholar 

  28. McTigue, K. M., Conroy, M. B., Hess, R., et al. (2009). Using the internet to translate an evidence-based lifestyle intervention into practice. Telemed J E Health., 15(9), 851–858. doi:10.1089/tmj.2009.0036.

    Article  PubMed  Google Scholar 

  29. Matvienko, O. A., & Hoehns, J. D. (2009). A lifestyle intervention study in patients with diabetes or impaired glucose tolerance: Translation of a research intervention into practice. Journal of the American Board of Family Medicine, 22(5), 535–543. doi:10.3122/jabfm.2009.05.090012.

    Article  PubMed  Google Scholar 

  30. Mau, M. K., Keawe'aimoku Kaholokula, J., West, M. R., et al. (2010). Translating diabetes prevention into native Hawaiian and Pacific Islander communities: The PILI 'Ohana Pilot project. Progress in Community Health Partnerships, 4(1), 7–16. doi:10.1353/cpr.0.0111.

    Article  PubMed  Google Scholar 

  31. Seidel, M. C., Powell, R. O., Zgibor, J. C., Siminerio, L. M., & Piatt, G. A. (2008). Translating the Diabetes Prevention Program into an urban medically underserved community: A nonrandomized prospective intervention study. Diabetes Care, 31(4), 684–689. doi:10.2337/dc07-1869.

    Article  PubMed  Google Scholar 

  32. Aldana, S., Barlow, M., Smith, R., et al. (2006). A worksite diabetes prevention program: Two-year impact on employee health. AAOHN Journal, 54(9), 389–395.

    PubMed  Google Scholar 

  33. Boltri, J. M., Davis-Smith, Y. M., Seale, J. P., Shellenberger, S., Okosun, I. S., & Cornelius, M. E. (2008). Diabetes prevention in a faith-based setting: Results of translational research. Journal of Public Health Management and Practice, 14(1), 29–32. doi:10.1097/01.PHH.0000303410.66485.91.

    PubMed  Google Scholar 

  34. Davis-Smith, Y. M., Boltri, J. M., Seale, J. P., Shellenberger, S., Blalock, T., & Tobin, B. (2007). Implementing a diabetes prevention program in a rural African–American church. Journal of the National Medical Association, 99(4), 440–446.

    PubMed  Google Scholar 

  35. Dodani, S., & Fields, J. Z. (2010). Implementation of the fit body and soul, a church-based life style program for diabetes prevention in high-risk African Americans: a feasibility study. The Diabetes Educator, 36(3), 465–472. doi:10.1177/0145721710366756.

    Article  PubMed  CAS  Google Scholar 

  36. Diabetes Prevention Program Research Group. (2003). Costs associated with the primary prevention of type 2 diabetes in the Diabetes Prevention Program. Diabetes Care, 26, 36–47.

    Article  Google Scholar 

  37. Katula JA, Vitolins MZ, Espeland M, et al. Translating diabetes prevention: Healthy living partnerships to prevent diabetes (HELP PD). Diabetes. 2010:1739-P.

  38. Katula, J. A., Vitolins, M. Z., Rosenberger, E. L., et al. (2010). Healthy Living Partnerships to Prevent Diabetes (HELP PD): design and methods. Contemporary Clinical Trials, 31(1), 71–81. doi:10.1016/j.cct.2009.09.002.

    Article  PubMed  Google Scholar 

  39. Albright, A., Araujo, R., Brownson, C., et al. (2009). AADE position statement: Community health workers in diabetes management and prevention. The Diabetes Educator, 35, 48S–52S.

    Article  Google Scholar 

  40. Glasgow, R. E., & Emmons, K. M. (2007). How can we increase translation of research into practice? Types of evidence needed. Annual Review of Public Health, 28, 413–433.

    Article  PubMed  Google Scholar 

  41. Oakley, A., Strange, V., Bonell, C., Allen, E., & Stephenson, J. (2006). Process evaluation in randomized controlled trials of complex interventions. British Medical Journal, 332, 413–416.

    Article  PubMed  Google Scholar 

  42. Castro, F. G., Barrera, M., & Martinez, C. R. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fit and fidelity. Prevention Science, 5, 41–45.

    Article  PubMed  Google Scholar 

  43. Santacroce, S. J., Maccarelli, L. M., & Grey, M. (2004). Intervention fidelity. Nursing Research, 53, 63–66.

    Article  PubMed  Google Scholar 

  44. Rollnick, S., Miller, W. R., & Butler, C. C. (2007). Motivational interviewing in health care. NY: Guilford Press.

    Google Scholar 

  45. Im, E. O., Lee, B., Hwang, H., et al. (2010). "A waste of time": Hispanic women's attitudes toward physical activity. Women & Health, 50(6), 563–579. doi:10.1080/03630242.2010.510387.

    Article  Google Scholar 

  46. Treuhaft S, Karpyn A. The grocery gap: Who has access to healthy food and why it matters. 2010. http://www.policylink.org/site/c.lkIXLbMNJrE/b.5860321/k.A5BD/The_Grocery_Gap.htm.

  47. Merriam, P. A., Tellez, T. L., Rosal, M., et al. (2009). Methodology of a diabetes prevention translational research project utilizing a community–academic partnership for implementation in an underserved Latino community. BMC Medical Research Methodology, 9, 20.

    Article  PubMed  Google Scholar 

  48. Lin, E. H. B., Katon, W., VonKorff, M., et al. (2004). Relationship of depression and diabetes self-care, medication adherence, and preventive care. Diabetes Care, 27, 2154–2160.

    Article  PubMed  Google Scholar 

  49. Elfhag, K., & Rossner, S. (2005). Who succeeds in maintaining weight loss? A conceptual review of factors associated with weight loss maintenance and weight regain. Obesity Review., 6, 67–85.

    Article  CAS  Google Scholar 

  50. Tuomilehto, J., Lindstrom, J., Eriksson, J. G., et al. (2001). Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The New England Journal of Medicine, 344, 1343–1350.

    Article  PubMed  CAS  Google Scholar 

  51. Baron, G., Ravaud, P., Samson, A., & Giraudeau, B. (2008). Missing data in randomized controlled trials of rheumatoid arthritis with radiographic outcomes: A simulation study. Arthritis and Rheumatism, 59(1), 25–31. doi:10.1002/art.23253.

    Article  PubMed  Google Scholar 

  52. Volpp, K. G., John, L. K., Troxel, A. B., Norton, L., Fassbender, J., & Loewenstein, G. (2008). Financial incentive-based approaches for weight loss: A randomized trial. Journal of the American Medical Association, 300(22), 2631–2637.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgment

The author thanks Heather Jacobs, MPH for assistance in manuscript preparation

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Correspondence to Robin Whittemore PhD, APRN, FAAN.

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Implications

Practice: To obtain optimal reach, efficacy, adoption, implementation, and maintenance of diabetes prevention translational programs, a variety of programs, settings, and providers are necessary.

Policy: Resources for diabetes prevention programs are needed to enhance the ability to reach diverse adults at-risk for type 2 diabetes and to implement diabetes prevention programs in clinical and community settings.

Research: Future research needs to examine mechanisms for dissemination and implementation of diabetes prevention programs in clinical and community settings as well as examine mechanisms for efficient coordination of programs with follow-up.

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Whittemore, R. A systematic review of the translational research on the Diabetes Prevention Program. Behav. Med. Pract. Policy Res. 1, 480–491 (2011). https://doi.org/10.1007/s13142-011-0062-y

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