Quasi-experimental evaluation of a nationwide diabetes prevention programme

Lemp, Julia M.; Bommer, Christian; Xie, Min; Michalik, Felix; Jani, Anant; Davies, Justine I.; Bärnighausen, Till; Vollmer, Sebastian; Geldsetzer, Pascal

doi:10.1038/s41586-023-06756-4

Cited by 8 publications

(3 citation statements)

References 60 publications

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“…However, findings from the Diabetes Prevention Program Outcomes Study and Look AHEAD (Action for Health in Diabetes) did not show a protective effect of lifestyle intervention on these outcomes [ 34 ]. In a recent study with over 2 million participants, lifestyle intervention, including personalized support, healthier diets, and increased physical activity, led to an average 15 mg/dL reduction in blood glucose levels among individuals with prediabetes [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prediabetes is an intermediate metabolic state between normoglycemia and diabetes, with primary complications leading to diabetic microvascular complications (DMC) such as retinopathy, neuropathy, and nephropathy [ 2 – 4 ]. Considering the substantial public health impact attributed to diabetes, the implementation of early intervention strategies for individuals with prediabetes holds paramount practical significance [ 2 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Combined associations of visceral adipose tissue and adherence to a Mediterranean lifestyle with T2D and diabetic microvascular complications among individuals with prediabetes

Chen,

Liu,

Cao

et al. 2024

Cardiovasc Diabetol

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Background It’s unclear if excess visceral adipose tissue (VAT) mass in individuals with prediabetes can be countered by adherence to a Mediterranean lifestyle (MEDLIFE). We aimed to examine VAT mass, MEDLIFE adherence, and their impact on type 2 diabetes (T2D) and diabetic microvascular complications (DMC) in individuals with prediabetes. Methods 11,267 individuals with prediabetes from the UK Biobank cohort were included. VAT mass was predicted using a non-linear model, and adherence to the MEDLIFE was evaluated using the 25-item MEDLIFE index, encompassing categories such as “Mediterranean food consumption,” “Mediterranean dietary habits,” and “Physical activity, rest, social habits, and conviviality.” Both VAT and MEDLIFE were categorized into quartiles, resulting in 16 combinations. Incident cases of T2D and related DMC were identified through clinical records. Cox proportional-hazards regression models were employed to examine associations, adjusting for potential confounding factors. Results Over a median follow-up of 13.77 years, we observed 1408 incident cases of T2D and 714 cases of any DMC. High adherence to the MEDLIFE, compared to the lowest quartile, reduced a 16% risk of incident T2D (HR: 0.84, 95% CI: 0.71–0.98) and 31% for incident DMC (0.69, 0.56–0.86). Conversely, compared to the lowest quartile of VAT, the highest quartile increased the risk of T2D (5.95, 4.72–7.49) and incident any DMC (1.79, 1.36–2.35). We observed an inverse dose-response relationship between MEDLIFE and T2D/DMC, and a dose-response relationship between VAT and all outcomes (P for trend < 0.05). Restricted cubic spline analysis confirmed a nearly linear dose-response pattern across all associations. Compared to individuals with the lowest MEDLIFE quartile and highest VAT quartile, those with the lowest T2D risk had the lowest VAT and highest MEDLIFE (0.12, 0.08–0.19). High MEDLIFE was linked to reduced T2D risk across all VAT categories, except in those with the highest VAT quartile. Similar trends were seen for DMC. Conclusion High adherence to MEDLIFE reduced T2D and MDC risk in individuals with prediabetes, while high VAT mass increases it, but MEDLIFE adherence may offset VAT’s risk partly. The Mediterranean lifestyle’s adaptability to diverse populations suggests promise for preventing T2D.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined associations of visceral adipose tissue and adherence to a Mediterranean lifestyle with T2D and diabetic microvascular complications among individuals with prediabetes

Chen,

Liu,

Cao

et al. 2024

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…England also needs The BMJ to advocate strongly for initiatives that promote health and deliver primary prevention of disease, such as expanding the evidence based and effective diabetes prevention programme and providing healthy, delicious, sustainable school meals for all children in England 910…”

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confidence: 99%