Prevention of Diabetes Through Lifestyle Intervention: Lessons Learned from the Diabetes Prevention Program and Outcomes Study and its Translation to Practice

Abstract

A number of strategies have been used to delay or prevent the development of type 2 diabetes mellitus (T2D) in high-risk adults, such as diet, exercise, medications, and surgery. This report focuses on the nutritional lessons learned from implementation of the Intensive Lifestyle Intervention (ILI) in the DPP and its follow-up DPPOS that looked at weight loss through modification of diet and exercise. The Diabetes Prevention Program (DPP) is a large clinical trial, sponsored by the National Institutes of Health, designed to look at several strategies to prevent conversion to type 2 diabetes (T2D) by adults with prediabetes (IGT/IFG), including ILI. The ~3800 ethnically diverse participants (46 % reported nonwhite race) were overweight, had impaired glucose tolerance (IGT), and impaired fasting glucose (IFG). Treatments were assigned randomly. The Diabetes Prevention Program Outcomes Study (DPPOS) is a follow-up study that evaluated the long-term outcomes of the clinical trial.

Trial registration: DPP is registered in www.clinicaltrials.gov (NCT00004992) and DPPOS (NCT 00038727).

Appendix 1. DPPOS Research Group Investigators

* denotes Principal Investigator

** denotes Program Coordinator

Pennington Biomedical Research Center (Baton Rouge, LA)

George A. Bray, MD*

Annie Chatellier, RN, CCRC**

Crystal Duncan, LPN

Frank L. Greenway, MD

Erma Levy, RD

Donna H. Ryan, MD

University of Chicago (Chicago, IL)

David Ehrmann, MD*

Margaret J. Matulik, RN, BSN**

Kirsten Czech, MS

Catherine DeSandre, BA

Jefferson Medical College (Philadelphia, PA)

Barry J. Goldstein, MD, PhD*

Kevin Furlong, DO*

Kellie A. Smith, RN, MSN**

Wendi Wildman, RN**

Constance Pepe, MS, RD

University of Miami (Miami, FL)

Ronald B. Goldberg, MD*

Jeanette Calles, MSEd**

Juliet Ojito, RN**

Sumaya Castillo-Florez, MPH

Hermes J. Florez, MD, PhD

Anna Giannella, RD, MS

Olga Lara

Beth Veciana

The University of Texas Health Science Center (San Antonio, TX)

Steven M. Haffner, MD, MPH*

Helen P. Hazuda, PhD*

Maria G. Montez, RN, MSHP, CDE**

Carlos Lorenzo, MD, PhD

Arlene Martinez, RN, BSN, CDE

University of Colorado (Denver, CO)

Richard F. Hamman, MD, DrPH*

Dana Dabelea, MD, PhD*

Lisa Testaverde, MS**

Alexis Bouffard, MA, RN, BSN

Tonya Jenkins, RD, CDE

Dione Lenz, RN, BSN, CDE

Leigh Perreault, MD

David W. Price, MD

Sheila C. Steinke, MS

Joslin Diabetes Center (Boston, MA)

Edward S. Horton, MD*

Catherine S. Poirier, RN, BSN**

Kati Swift, RN, BSN**

Enrique Caballero, MD

Barbara Fargnoli, RD

Ashley Guidi, BS

Mathew Guido, BA

Sharon D. Jackson, MS, RD, CDE

Lori Lambert, MS, RD, LD

Kathleen E. Lawton, RN

Sarah Ledbury, Med, RD

Jessica Sansoucy, BS

Jeanne Spellman, RD

VA Puget Sound Health Care System and University of Washington (Seattle, WA)

Steven E. Kahn, MB, ChB*

Brenda K. Montgomery, RN, BSN, CDE**

Wilfred Fujimoto, MD

Robert H. Knopp, MD (deceased)

Edward W. Lipkin, MD

Ivy Morgan-Taggart

Anne Murillo, BS

Dace Trence, MD

Lonnese Taylor, RN, BS

April Thomas, RD, MPH, CDE

Elaine C. Tsai, MD, MPH

University of Tennessee (Memphis, TN)

Abbas E. Kitabchi, PhD, MD, FACP*

Mary E. Murphy, RN, MS, CDE, MBA**

William B. Applegate, MD, MPH

Michael Bryer-Ash, MD

Samuel Dagogo-Jack, MD, MSc, FRCP, FACP

Sandra L. Frieson, RN

Helen Lambeth, RN, BSN

Lynne C. Lichtermann, RN, BSN

Hooman Otkaei, MD

Lily M.K. Rutledge, RN, BSN

Amy R. Sherman, RD, LD

Clara M. Smith, RD, MHP, LDN

Judith E. Soberman, MD

Beverly Williams-Cleaves, MD

Northwestern University’s Feinberg School of Medicine (Chicago, IL)

Boyd E. Metzger, MD*

Mark E. Molitch, MD*

Mariana K. Johnson, MS, RN**

Mimi M. Giles, MS, RD

Diane Larsen, BS

Samsam C. Pen, BA

Massachusetts General Hospital (Boston, MA)

David M. Nathan, MD*

Mary Larkin, MSN*

Charles McKitrick, BSN**

Heather Turgeon, BSN

Ellen Anderson, MS, RD

Laurie Bissett, MS, RD

Kristy Bondi, BS

Enrico Cagliero, MD

Kali D’Anna

Linda Delahanty, MS, RD

Jose C. Florez, MD, PhD

Valerie Goldman, MS, RD

Alexandra Poulos

Elyse Raymond, BS

Christine Stevens, RN

Beverly Tseng

University of California-San Diego (San Diego, CA)

Elizabeth Barrett-Connor, MD*

Mary Lou Carrion-Petersen, RN, BSN**

Lauren N. Claravall, BS

Jonalle M. Dowden, BS

Javiva Horne, RD

Diana Leos, RN, BSN

Sundar Mudaliar, MD

Jean Smith, RN

Simona Szerdi Janisch, BS

Karen Vejvoda, RN, BSN, CDE, CCRC

St. Luke’s-Roosevelt Hospital (New York, NY)

F. Xavier Pi-Sunyer, MD*

Jane E. Lee, MS**

Sandra T. Foo, MD

Susan Hagamen, MS, RN, CDE

Indiana University (Indianapolis, IN)

David G. Marrero, PhD*

Susie M. Kelly, RN, CDE**

Marcia A. Jackson**

Gina McAtee**

Ronald T. Ackermann, MD

Edwin S. Fineberg, MD

Angela Hadden

Marion S. Kirkman, MD

Kieren J. Mather, MD

Paris J. Roach, MD

Madelyn L. Wheeler, RD

Medstar Health Research Institute (Washington, DC)

Robert E. Ratner, MD*

Vanita Aroda, MD*

Sue Shapiro, RN, BSN, CCRC**

Catherine Bavido-Arrage, MS, RD, LD

Lilia Leon

Gabriel Uwaifo, MD

Debra Wells-Thayer, NP, CDE

Renee Wiggins, RD

University of Southern California/UCLA Research Center (Alhambra, CA)

Mohammed F. Saad, MD*

Karol Watson, MD*

Medhat Botrous, MD**

Sujata Jinagouda, MD**

Maria Budget

Claudia Conzues

Perpetua Magpuri

Kathy Ngo

Kathy Xapthalamous

Washington University (St. Louis, MO)

Neil H. White, MD, CDE*

Samia Das, MS, MBA, RD, LD**

Ana Santiago, RD

Angela L. Brown, MD

Cormarie Wernimont, RD, LD

Johns Hopkins School of Medicine (Baltimore, MD)

Christopher D. Saudek, MD* (deceased)

Sherita Hill Golden, MD, MHS, FAHA*

Tracy Whittington, BS**

Frederick L. Brancati, MD, MHS (deceased)

Jeanne M. Clark, MD

Alicia Greene

Dawn Jiggetts

Henry Mosley

John Reusing

Richard R. Rubin, PhD (deceased)

Shawne Stephens

Evonne Utsey

University of New Mexico (Albuquerque, NM)

David S. Schade, MD*

Karwyn S. Adams, RN, MSN**

Claire Hemphill, RN, BSN**

Penny Hyde, RN, BSN**

Janene L. Canady, RN, BSN, CDE

Kathleen Colleran, MD

Ysela Gonzales

Doris A. Hernandez-McGinnis

Carolyn King, MEd

Albert Einstein College of Medicine (Bronx, NY)

Jill Crandall, MD*

Janet O. Brown, RN, MPH, MSN**

Elsie Adorno, BS

Helena Duffy, MS, C-ANP

Angela Goldstein, FNP-C, NPP, CSW

Jennifer Lukin, BA

Helen Martinez, RN, MSN, FNP-C

Dorothy Pompi, BA

Harry Shamoon, MD

Jonathan Scheindlin, MD

Elizabeth A. Walker, RN, DNSc, CDE

Judith Wylie-Rosett, EdD, RD

University of Pittsburgh (Pittsburgh, PA)

Trevor Orchard, MD*

Andrea Kriska, PhD*

Susan Jeffries, RN, MSN**

M. Kaye Kramer, BSN, MPH**

Marie Smith, RN, BSN**

Catherine Benchoff

Stephanie Guimond, BS

Jessica Pettigrew, CMA

Debra Rubinstein, MD

Linda Semler, MS, RD

Elizabeth Venditti, PhD

Valarie Weinzierl, MPH

University of Hawaii (Honolulu, HI)

Richard F. Arakaki, MD*

Narleen K. Baker-Ladao, BS**

Mae K. Isonaga, RD, MPH**

Nina E. Bermudez, MS

Marjorie K. Mau, MD

Southwest American Indian Centers (Phoenix, AZ; Shiprock, NM; Zuni, NM)

William C. Knowler, MD, DrPH*

Norman Cooeyate**

Mary A. Hoskin, RD, MS**

Camille Natewa**

Carol A. Percy, RN, MS**

Kelly J. Acton, MD, MPH

Vickie L. Andre, RN, FNP

Shandiin Begay, MPH

Brian C. Bucca, OD, FAAO

Sherron Cook

Matthew S. Doughty, MD

Justin Glass, MD

Martia Glass, MD

Robert L. Hanson, MD, MPH

Doug Hassenpflug, OD

Louise E. Ingraham, MS, RD, LN

Kathleen M. Kobus, RNC-ANP

Jonathan Krakoff, MD

Catherine Manus, LPN

Cherie McCabe

Sara Michaels, MD

Tina Morgan

Julie A. Nelson, RD

Robert J. Roy

Miranda Smart

Darryl P. Tonemah, PhD

Charlton Wilson, MD

George Washington University Biostatistics Center (DPP Coordinating Center Rockville, MD)

Sarah Fowler, PhD*

Marinella Temprosa, PhD*

Michael D. Larsen, PhD*

Tina Brenneman**

Hanna Sherif, MS**

Sharon L. Edelstein, ScM**

Solome Abebe, MS

Julie Bamdad, MS

Melanie Barkalow

Joel Bethepu

Tsedenia Bezabeh

Nicole Butler

Jackie Callaghan

Costas Christophi, PhD

Mary Foulkes, PhD

Yuping Gao

Robert Gooding

Adrienne Gottlieb

Nisha Grover

Heather Hoffman, PhD

Kathleen Jablonski, PhD

Richard Katz, MD

Preethy Kolinjivadi, MS

John M. Lachin, ScD

Yong Ma, PhD

Qing Pan, PhD

Susan Reamer

Alla Sapozhnikova

Lifestyle Resource Core

Elizabeth M. Venditti, PhD*

Andrea M. Kriska, PhD

Linda Semler, MS, RD

Valarie Weinzierl, MPH

Central Biochemistry Laboratory (Seattle, WA)

Santica Marcovina, PhD, ScD*

Greg Strylewicz, PhD**

John Albers, PhD

Epidemiological Cardiology Research Center- Epicare (Winston-Salem, NC)

Ronald J. Prineas, MD, PhD*

Teresa Alexander

Charles Campbell, MS

Sharon Hall

Susan Hensley

Yabing Li, MD

Margaret Mills

Elsayed Soliman, MD

Zhuming Zhang, MD

Fundus Photo Reading Center (Madison, WI)

Ronald Danis, MD*

Matthew Davis, MD*

Larry Hubbard*

Ryan Endres**

Deborah Elsas**

Samantha Johnson**

Vonnie Gama

Anne Goulding

Carotid Ultrasound

Gregory Evans

CT Scan Reading Center

Elizabeth Stamm

Neurocognitive Assessment Group

Jose A. Luchsinger, MD, MPH

NIH/NIDDK (Bethesda, MD)

Judith Fradkin, MD

Sanford Garfield, PhD

Centers for Disease Control & Prevention (Atlanta, GA)

Edward Gregg, PhD

Ping Zhang, PhD

University of Michigan (Ann Arbor, MI)

William H. Herman, MD, MPH

Morton B. Brown, PhD

Nutrition Coding Center (Columbia, SC)

Elizabeth Mayer-Davis, PhD*

Robert R. Moran, PhD**

Quality of Well-Being Center (La Jolla, CA)

Ted Ganiats, MD*

Andrew J. Sarkin, PhD**

Naomi Katzir

Erik Groessl, PhD

Coronary Artery Calcification Reading Center

Matthew Budoff, MD

Chris Dailing

Genetics Working Group

Jose C. Florez, MD, PhD^{1, 2}

David Altshuler, MD, PhD^{1, 2}

Liana K. Billings, MD¹

Ling Chen, MS¹

Maegan Harden, BS²

Robert L. Hanson, MD, MPH³

William C. Knowler, MD, DrPH³

Toni I. Pollin, PhD⁴

Alan R. Shuldiner, MD⁴

Kathleen Jablonski, PhD⁵

Paul W. Franks, PhD, MPhil, MS^{6, 7, 8}

Marie-France Hivert, MD⁹

1 = Massachusetts General Hospital

2 = Broad Institute

3 = NIDDK

4 = University of Maryland

5 = Coordinating Center

6 = Lund University, Sweden

7 = Umeå University, Sweden

8 = Harvard School of Public Health

9 = Université de Sherbrooke