University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pittsburgh, Pennsylvania.
Gallatin City-County Health Department, Bozeman, Montana.
Diabetes Educ. 2018 Apr;44(2):118-129. doi: 10.1177/0145721718759982. Epub 2018 Mar 7.
Purpose The purpose of this study is to evaluate the feasibility and effectiveness of an adapted Diabetes Prevention Program (DPP) lifestyle program, DPP Group Lifestyle Balance (GLB), delivered in 3 economically diverse senior/community centers. Methods The DPP-GLB was implemented in 3 senior/community centers in Allegheny County, PA. A 6-month delayed control intervention design was used. Participants were randomized to begin the DPP-GLB immediately (immediate) or after a 6-month delay (delayed). Adults (n = 134; mean age = 62.8 years) with BMI ≥24 kg/m and prediabetes and/or the metabolic syndrome took part. Weight, physical activity (PA), and diabetes and cardiovascular disease (CVD) risk factors were assessed at 6, 12, and 18 months from baseline. Results At 6 months, the immediate group demonstrated greater mean weight loss than the delayed control group as well as significantly greater improvements in PA, A1C, fasting insulin, and waist circumference. In pre-post analyses, both randomized groups showed similar success that was maintained at 18 months. Conclusions The DPP-GLB delivered in economically diverse community centers was effective in this group of older adults. These findings support provision of coverage for prevention programs in older adults at risk for diabetes/CVD, which is important considering the large number of individuals who will be Medicare eligible in the near future.
目的 本研究旨在评估经过改编的糖尿病预防计划(DPP)生活方式项目(DPP 小组生活平衡(GLB))在 3 个经济多样化的老年/社区中心实施的可行性和有效性。
方法 DPP-GLB 在宾夕法尼亚州阿勒格尼县的 3 个老年/社区中心实施。采用 6 个月延迟对照干预设计。参与者被随机分配立即(立即)或延迟 6 个月开始 DPP-GLB(延迟)。参与者为 BMI≥24kg/m2 且患有前驱糖尿病和/或代谢综合征的成年人,年龄为 62.8 岁。在基线时,体重、身体活动(PA)以及糖尿病和心血管疾病(CVD)风险因素进行了 6、12 和 18 个月的评估。
结果 在 6 个月时,立即组的平均体重减轻量大于延迟对照组,且 PA、A1C、空腹胰岛素和腰围的改善幅度显著更大。在预前后分析中,两组随机组的成功率均相似,并在 18 个月时得到维持。
结论 在经济多样化的社区中心提供 DPP-GLB 对这组老年人有效。这些发现支持为有糖尿病/CVD 风险的老年人提供预防计划的覆盖,这在未来不久将有大量符合医疗保险资格的人考虑时非常重要。