Pedley Carolyn F, Case L Douglas, Blackwell Caroline S, Katula Jeffrey A, Vitolins Mara Z
Wake Forest Baptist Medical Center, Department of Internal Medicine, Winston-Salem, NC, USA.
Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC, USA.
Diabetes Metab Syndr. 2018 May;12(3):215-220. doi: 10.1016/j.dsx.2017.09.011. Epub 2017 Sep 23.
Large-scale clinical trials and translational studies have demonstrated that weight loss achieved through diet and physical activity reduced the development of diabetes in overweight individuals with prediabetes. These interventions also reduced the occurrence of metabolic syndrome and risk factors linked to other chronic conditions including obesity-driven cancers and cardiovascular disease. The Healthy Living Partnerships to Prevent Diabetes (HELP PD) was a clinical trial in which participants were randomized to receive a community-based lifestyle intervention translated from the Diabetes Prevention Program (DPP) or an enhanced usual care condition. The objective of this study is to compare the 12 and 24 month prevalence of metabolic syndrome in the two treatment arms of HELP PD.
The intervention involved a group-based, behavioral weight-loss program led by community health workers monitored by personnel from a local diabetes education program. The enhanced usual care condition included dietary counseling and written materials.
HELP PD included 301 overweight or obese participants (BMI 25-39.9kg/m) with elevated fasting glucose levels (95-125mg/dl). At 12 and 24 months of follow-up there were significant improvements in individual components of the metabolic syndrome: fasting blood glucose, waist circumference, HDL, triglycerides and blood pressure and the occurrence of the metabolic syndrome in the intervention group compared to the usual care group.
This study demonstrates that a community diabetes prevention program in participants with prediabetes results in metabolic benefits and a reduction in the occurrence of the metabolic syndrome in the intervention group compared to the enhanced usual care group.
大规模临床试验和转化研究表明,通过饮食和体育活动实现体重减轻可降低糖尿病前期超重个体患糖尿病的风险。这些干预措施还减少了代谢综合征的发生以及与其他慢性疾病相关的危险因素,包括肥胖驱动的癌症和心血管疾病。预防糖尿病健康生活伙伴关系(HELP PD)是一项临床试验,参与者被随机分配接受从糖尿病预防计划(DPP)转化而来的基于社区的生活方式干预或强化常规护理。本研究的目的是比较HELP PD两个治疗组中代谢综合征的12个月和24个月患病率。
干预措施包括由社区卫生工作者领导、当地糖尿病教育项目人员监督的基于小组的行为减肥计划。强化常规护理包括饮食咨询和书面材料。
HELP PD纳入了301名超重或肥胖参与者(BMI 25 - 39.9kg/m),空腹血糖水平升高(95 - 125mg/dl)。在随访的12个月和24个月时,代谢综合征的各个组成部分:空腹血糖、腰围、高密度脂蛋白、甘油三酯和血压以及干预组中代谢综合征的发生率与常规护理组相比有显著改善。
本研究表明,与强化常规护理组相比,针对糖尿病前期参与者的社区糖尿病预防计划能带来代谢益处,并降低干预组中代谢综合征的发生率。