Vitolins Mara Z, Isom Scott P, Blackwell Caroline S, Kernodle Donna, Sydell Joyce M, Pedley Carolyn F, Katula Jeffrey A, Case L Douglas, Goff David C
Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Wake Forest Baptist Medical Center, Joslin Diabetes Center, Winston-Salem, NC, USA.
Transl Behav Med. 2017 Jun;7(2):371-378. doi: 10.1007/s13142-016-0447-z.
A number of research studies have attempted to translate the behavioral lifestyle intervention delivered in the Diabetes Prevention Program (DPP). To compare the active interventions of two trials, Diabetes Prevention Program DPP and Healthy Living Partnerships to Prevent Diabetes (HELP PD), after 1 and 2 years of intervention. DPP included 3234 adults with prediabetes randomized to intensive lifestyle intervention, metformin, troglitazone, or placebo. The lifestyle intervention, professionally delivered to individuals in a clinical setting, focused on diet and increased physical activity. HELP PD, a community-based translation of DPP, included 301 adults randomized to receive intensive lifestyle intervention or enhanced usual care. Mean weight-losses at 1 year (6.9 kg in DPP, 6.4 kg in HELP PD) and 2 years (5.5 kg in DPP, 4.4 kg in HELP PD) were similar across studies. Reductions in glucose were also similar across studies at both time points (5.2 mg/dL in DPP and 4.1 mg/dL in HELP PD at 1 year; 1.8 mg/dL and 1.6 mg/dL at 2 years). HELP PD participants achieved larger reductions in triglycerides at 1 and 2 years (38.4 mg/dL and 34.9 mg/dL, respectively) than DPP participants (24.8 mg/dL and 22.4 mg/dL). High-density lipoprotein decreased in HELP PD participants at year 1 (-0.6 mg/dL) and increased in DPP (1.2 mg/dL) but there were no significant differences in year 2. HELP PD, a community model for diabetes prevention, was similar to DPP in reducing body weight and lowering blood glucose, both important risk factors that should be controlled to reduce risk for developing type 2 diabetes.
一些研究试图将糖尿病预防计划(DPP)中提供的行为生活方式干预进行转化。为了比较两项试验——糖尿病预防计划(DPP)和预防糖尿病健康生活伙伴关系(HELP PD)——在干预1年和2年后的积极干预措施。DPP纳入了3234名糖尿病前期成年人,他们被随机分配至强化生活方式干预组、二甲双胍组、曲格列酮组或安慰剂组。生活方式干预由专业人员在临床环境中提供给个体,重点是饮食和增加身体活动。HELP PD是DPP基于社区的转化版本,纳入了301名成年人,他们被随机分配接受强化生活方式干预或强化常规护理。两项研究中,1年时的平均体重减轻情况(DPP组为6.9千克,HELP PD组为6.4千克)和2年时的平均体重减轻情况(DPP组为5.5千克,HELP PD组为4.4千克)相似。在两个时间点上,两项研究中血糖的降低情况也相似(1年时,DPP组降低5.2毫克/分升,HELP PD组降低4.1毫克/分升;2年时,分别降低1.8毫克/分升和1.6毫克/分升)。HELP PD组参与者在1年和2年时甘油三酯的降低幅度(分别为38.4毫克/分升和34.9毫克/分升)大于DPP组参与者(分别为24.8毫克/分升和22.4毫克/分升)。高密度脂蛋白在HELP PD组参与者中于第1年下降了(-0.6毫克/分升),在DPP组中上升了(1.2毫克/分升),但在第2年没有显著差异。HELP PD作为一种糖尿病预防的社区模式,在减轻体重和降低血糖方面与DPP相似,而体重和血糖都是为降低2型糖尿病发病风险而应加以控制的重要危险因素。