Wardian Jana L, True Mark W, Sauerwein Tom J, Watson Nina A, Hoover Austin M
Diabetes Center of Excellence (DCOE), Wilford Hall Ambulatory Surgical Center (WHASC), 2200 Bergquist, Joint Base San Antonio-Lackland, TX 78236.
Endocrinology Service, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Joint Base San Antonio, Fort Sam Houston, TX 78253.
Mil Med. 2018 Jan 1;183(1-2):e138-e143. doi: 10.1093/milmed/usx058.
The Diabetes Prevention Program (DPP) demonstrated that lifestyle intervention programs were effective in preventing or delaying the onset of diabetes. The Group Lifestyle Balance (GLB) program translated the DPP curriculum into a 12-wk group intervention for those at risk for diabetes. This retrospective evaluation examined clinical outcomes for patients in the Diabetes Center of Excellence GLB program located at Wilford Hall Ambulatory Surgical Center from 2009 to 2013. Objectives included determining rates of retention, demographic characteristics of program completers, and changes in metabolic surrogates of disease prevalence.
Adults with prediabetes or metabolic syndrome (MetS) were referred to the GLB program. Updated participant metabolic data were collected at regular intervals during their participation.
During the 5-yr study, 704 patients attended the initial class. Overall, 52% of all participants completed the program with the greatest decline in participation occurring by the fourth week (30%). Baseline prevalence of conditions of interest for those who completed the program was prediabetes (93.2%), obesity (56.1%), and MetS (31.5%). GLB completers were older and retired (p < 0.05). A significant number of active duty military members (44.9%, p < 0.01, n = 53) dropped out of the program before the fourth week. Furthermore, those who completed the program saw a 2.0% reduction in prediabetes prevalence (p < 0.001), obesity decreased by 8.7% (p < 0.001), and MetS decreased by 6.8% (p < 0.01). Significant differences were found for central obesity, triglycerides, and fasting blood sugar (p < 0.001).
The GLB program is a valuable DPP and was effective at improving clinical outcomes and reducing the incidence of prediabetes, obesity, and MetS for participants who completed the program. Every effort should be made to support and encourage GLB participants to complete the program.
糖尿病预防计划（DPP）表明，生活方式干预计划在预防或延缓糖尿病发病方面是有效的。团体生活方式平衡（GLB）计划将DPP课程转化为针对糖尿病高危人群的为期12周的团体干预。这项回顾性评估研究了2009年至2013年位于威尔福德霍尔门诊手术中心的卓越糖尿病中心GLB计划中患者的临床结果。目标包括确定留存率、计划完成者的人口统计学特征以及疾病患病率代谢替代指标的变化。
患有糖尿病前期或代谢综合征（MetS）的成年人被推荐参加GLB计划。在参与者参与期间定期收集更新的代谢数据。
在为期5年的研究中，704名患者参加了初始课程。总体而言，所有参与者中有52%完成了该计划，参与率下降幅度最大发生在第四周（30%）。完成该计划的人群中，感兴趣疾病的基线患病率为糖尿病前期（93.2%）、肥胖（56.1%）和代谢综合征（31.5%）。GLB计划完成者年龄较大且已退休（p<0.05）。大量现役军人（44.9%，p<0.01，n=53）在第四周前退出了该计划。此外，完成该计划的人糖尿病前期患病率降低了2.0%（p<0.001），肥胖率降低了8.7%（p<0.001），代谢综合征降低了6.8%（p<0.01）。在中心性肥胖、甘油三酯和空腹血糖方面发现了显著差异（p<0.001）。
GLB计划是一项有价值的DPP计划，对于完成该计划的参与者，在改善临床结果以及降低糖尿病前期、肥胖和代谢综合征的发病率方面是有效的。应尽一切努力支持和鼓励GLB计划参与者完成该计划。
