One-Year Results of a Synthetic Intervention Model for the Primary Prevention of T2D among Elderly Individuals with Prediabetes in Rural China

Abstract

Objective: The objective of this study was to evaluate the effectiveness of a synthetic intervention model aimed at preventing type 2 diabetes and controlling plasma glucose, body weight and waist circumference in elderly individuals with prediabetes in rural China. Methods: We randomly assigned 434 (180 men and 254 women; mean age, 69 years; mean body mass index, 23.6 kg/m2) with prediabetes to either the intervention group or the control group. Each participant in the intervention group received synthetic intervention for 1 year. Results: The incidence of diabetes was 4.2% in the intervention group, versus 19.7% in the control group at the end of 1 year (p < 0.001). Compared with the control group, the intervention group experienced a great decrease in fasting glucose (−3.9 vs. 2.2 mg/dL, p < 0.001), body weight (−3.2 vs. 1.7 kg, p < 0.001), waist circumference (−2.4 vs. 1.0 cm, p < 0001), total cholesterol (−9.1 vs. −4.6 mg/dL. p = 0.014) and HbA1c (−1.0 vs. 0.1 mg %, p = 0.002) at the end of 1 year. Conclusions: The incidence of diabetes of the control group was higher than that of the intervention group. Besides, the synthetic intervention contributes to weight loss and glucose decrease, and may be effective in reducing the risk of diabetes among elderly individuals with prediabetes in rural China.

The effect of community-based programs on diabetes prevention in low- and middle-income countries: a systematic review and meta-analysis

“…We included six randomized controlled trials published between 2010 and 2017: three trials conducted in India [66–68], one in China [69], one in Brazil [70], and one in Vietnam [71]. Details of the methods, participants, intervention, comparison group, and outcome measures for each included trial are provided in Table 1.…”

“…Details of the methods, participants, intervention, comparison group, and outcome measures for each included trial are provided in Table 1. The randomization unit for four trials was the individual participants; two trials [68, 69] used the cluster randomization method. Of these two cluster RCTs, one study [68] pointed out that the result had been adjusted for clustering effect but did not mention the intraclass correlation coefficient (ICC) value, while the other [69] adjusted the results for age, sex, and other characteristics, but did not report applying adjustment aimed at the clustering effect.…”

Follow-up of blood glucose distribution characteristics in a health examination population in Chengdu from 2010 to 2016

“…[ 23 ] The Finnish Diabetes Prevention Study (DPS) reported that the cumulative incidence of diabetes was 11% in the intervention group and 23% in the control group after 4 years’ lifestyle intervention for IGT. [ 24 ] Hu et al [ 25 ] assigned 434 with prediabetes to either the intervention group or the control group, and participants in the intervention group received synthetic intervention for 1 year. They found that the incidence of diabetes was 4.2% in the intervention group, while the incidence of diabetes was 19.7% in the control group.…”

Dysglycemia-Based Chronic Disease: An American Association of Clinical Endocrinologists Position Statement

“…Population-based primordial prevention strategies are applicable in this stage. Primary prevention strategies are indicated for these individuals, such as structured lifestyle modifications resulting in weight loss and enhanced physical fitness, that improve metabolic and CVD risk factors and prevent progression to Stage 3 DBCD, or T2D (47,(120)(121)(122)(123)(124)(125)(126)(127). At present, prediabetes is still considered as a predisease, but with further scientific delineation, prediabetes may eventually meet criteria for a true disease state.…”