School of Health, Physical Education and Leisure Services, University of Northern Iowa, Cedar Falls, IA 50614-0241, USA.
J Am Board Fam Med. 2009 Sep-Oct;22(5):535-43. doi: 10.3122/jabfm.2009.05.090012.
The objectives of this study were to translate a research-validated lifestyle modification curriculum of the Diabetes Prevention Program (DPP) into a community-based program delivered by trained graduate students on a university campus and determine whether this delivery approach is effective in lowering risk factors of type 2 diabetes in at-risk adults.
A convenience sample of 29 prediabetic or type 2 diabetic patients completed a 12-month behavior modification intervention to achieve and maintain at least 7% weight loss and become more active. Changes in weight, waist and hip circumferences, blood pressure, metabolic biomarkers, physical activity levels, and medication were assessed.
At 6 and 12 months, 39% and 56% of patients had lost > or =5% of their weight. The mean weight loss at 12 months was 6%. Significant improvements were noted in most other anthropometric measurements and diastolic BP (-4.1 mm Hg). Significant reductions in total cholesterol (-11.7%), LDL-C (-7.6%), and HDL-C (-6.5%) were observed by 6 months but not at 12 months. Fasting glucose (-12%), systolic BP (-8.4 mm Hg), and diastolic BP (-7.0 mm Hg) were significantly improved in a subgroup of participants with at least 5% weight loss. HbA1c levels were associated with percentage weight loss. Twenty-seven percent of participants on diabetes medication had their drug discontinued.
Weight-related findings of this study are comparable with those of the DPP. DPP curriculum implemented in a nonclinical setting can help some adults at-risk for or in early stages of diabetes improve anthropometric and certain metabolic outcomes.
本研究的目的是将经过研究验证的糖尿病预防计划（DPP）生活方式改变课程转化为基于社区的项目，由经过培训的研究生在大学校园实施，并确定这种交付方法是否能有效降低高危成年人 2 型糖尿病的风险因素。
对 29 名糖尿病前期或 2 型糖尿病患者进行了便利抽样，他们完成了为期 12 个月的行为改变干预，以实现并维持至少 7%的体重减轻并变得更活跃。评估体重、腰围和臀围、血压、代谢生物标志物、身体活动水平和药物的变化。
在 6 个月和 12 个月时，39%和 56%的患者体重减轻了>或=5%。12 个月时的平均体重减轻量为 6%。大多数其他人体测量指标和舒张压（-4.1mmHg）都有显著改善。6 个月时总胆固醇（-11.7%）、LDL-C（-7.6%）和 HDL-C（-6.5%）显著降低，但 12 个月时未降低。在至少减轻 5%体重的参与者亚组中，空腹血糖（-12%）、收缩压（-8.4mmHg）和舒张压（-7.0mmHg）显著改善。糖化血红蛋白（HbA1c）水平与体重减轻百分比相关。27%服用糖尿病药物的患者停止了用药。
本研究的体重相关结果与 DPP 的结果相当。在非临床环境中实施的 DPP 课程可以帮助一些有糖尿病风险或处于糖尿病早期的成年人改善人体测量和某些代谢结果。
