More than 80 million Americans have prediabetes, increasing their chances of developing type 2 diabetes and cardiovascular disease, according to the Centers for Disease Control and Prevention.
USF College of Public Health’s Dr. Janice Zgibor, associate professor in the department of epidemiology and biostatistics, and research colleagues set out to determine if weight loss and cardiovascular risk reduction was maintained following a lifestyle intervention.
Self-selection of a lifestyle intervention may be the key to reducing a patient’s risk of developing diabetes and its associated health complications, according to results.
Their study, “Influence of Patient-Centered Decision Making on Sustained Weight Loss and Risk Reduction Following Lifestyle Intervention Efforts in Rural Pennsylvania,” is published in the March issue of The Diabetes Educator.
Dr. Zgibor and colleagues examined eight rural Pennsylvania communities, focusing on individuals who were obese, but did not yet have diabetes.
Individuals were split into groups based on three different types of lifestyle interventions: a face-to-face meeting, instructional DVD or internet-based intervention. A fourth group was allowed to self-select, choosing one of the three intervention modalities of their preference.
“We cast the net broad and looked at the comparative effectiveness of different ways to deliver a diabetes prevention curriculum,” Dr. Zgibor said.
The study reached a total of 434 participants who were assigned to one of the four lifestyle intervention modality groups.
Despite the modality, all content for the intervention was the same, according to Dr. Zgibor.
Participants were asked to lose at least five percent of their body weight and to decrease at least one cardiovascular disease risk factor following the intervention.
Training for the intervention was provided by the University of Pittsburgh Diabetes Prevention Support Center and consisted of a 12-week comprehensive lifestyle behavior change program adapted from the lifestyle intervention used in the national Diabetes Prevention Program.
More than half of all participants in each intervention group lost at least five percent of their total body weight following the intervention and maintained that loss at their 18-month follow-up meeting, losing an average of 20 pounds.
The group with the largest achievement and maintenance of weight loss was the self-selection group, according to Dr. Zgibor. They were more than twice as likely to maintain that weight loss at 18 months.
They found the key to not only reducing diabetes and cardiovascular risk, but also sustained reduction of that risk, is self-selection of the modality in which the lifestyle intervention was delivered.
“That’s where we found the most impact, when people can decide what they want do to, it tends to be most effective,” Dr. Zgibor said.