Prevention of Diabetes Through Lifestyle Intervention: Lessons Learned from the Diabetes Prevention Program and Outcomes Study and its Translation to Practice
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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).
KeywordsLifestyle intervention Diabetes prevention Weight loss Physical activity Prevention Diabetes Overweight Type 2 diabetes Nutrition Lifestyle Diet Genetics
The Research Group gratefully acknowledges the commitment and dedication of the participants of the DPP and DPPOS. During the DPPOS, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health provided funding to the clinical centers and the Coordinating Center for the design and conduct of the study, and collection, management, analysis, and interpretation of the data. The Southwestern American Indian Centers were supported directly by the NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources, and the Department of Veterans Affairs supported data collection at many of the clinical centers. Funding also was provided by the National Institute of Child Health and Human Development, the National Institute on Aging, the National Eye Institute, the National Heart Lung and Blood Institute, the Office of Research on Women’s Health, the National Institute on Minority Health and Health Disparities, the Centers for Disease Control and Prevention, and the American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during the DPP, Lipha (Merck-Sante) provided medication and LifeScan Inc. donated materials during the DPP and DPPOS. The opinions expressed are those of the investigators and do not necessarily reflect the views of the funding agencies. A complete list of centers, investigators, and staff can be found in the Appendix.
Compliance with Ethics Guidelines
Conflict of Interest
Mary A. Hoskin declares that she has no conflict of interest.
George A. Bray has received research support through a grant from the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); has received compensation from Herbalife Nutrition Institute, Jason Pharmaceuticals, and Theracos Pharmaceuticals for service as a consultant; has received payment for lectures including service on speakers bureaus from the American Association of Clinical Endocrinologists; and has received royalties from contributions to the Handbook of Obesity, Up-to-Date, and CRC Press.
Kathy Hattaway declares that she has no conflict of interest.
Prajakta A. Khare-Ranade declares that she has no conflict of interest.
Jeremy Pomeroy declares that he has no conflict of interest.
Linda N. Semler has been issued a patent for the Group Lifestyle Balance™ program, but has disclaimed rights to licensing proceeds and has no personal financial interest in the licensing for the program.
Valarie A. Weinzierl declares that she has no conflict of interest.
Judith Wylie-Rosett has received research support through a grant from the NIH National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) for the Einstein-Sinai Diabetes Research Center and for DPP translation.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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