(Press-News.org) CHICAGO – Two adapted diabetes lifestyle interventions resulted in weight loss, as well as improvements in waist circumference and fasting plasma glucose level, for overweight or obese adults compared with usual care over a 15-month period, according to a report of a randomized trial published Online First by Archives of Internal Medicine, a JAMA Network publication.
An estimated 69 percent of U.S. adults are overweight or obese and lifestyle modifications that focus on modest weight loss (5 percent to 10 percent) and moderate-intensity physical activity are associated with a reduced incidence of type 2 diabetes mellitus (DM). However, there has been a failure to incorporate weight management into clinical practice, according to the study background.
Jun Ma, M.D., Ph.D., of the Palo Alto Medical Foundation Research Institute, Palo Alto, Calif., and colleagues evaluated two adapted Diabetes Prevention Program (DPP) lifestyle interventions among overweight or obese adults who were recruited from one primary care clinic and had pre-DM, metabolic syndrome, or both. The Evaluation of Lifestyle Interventions to Treat Elevated Cardiometabolic Risk in Primary Care (E-LITE) was a primary-care based randomized trial designed to evaluate the effectiveness of the adapted DPP lifestyle interventions.
"Proven effective in a primary care setting, the 2 DPP-based lifestyle interventions are readily scalable and exportable with potential for substantial clinical and public health impact," the authors note.
Participants were assigned to one of three groups: a coach-led group intervention (n=79), a self-directed DVD intervention (n=81) or usual care (n=81). The behavioral weight loss program was delivered during a 3-month intervention phase by a lifestyle coach or home-based DVD and then was followed by a 12-month maintenance phase, according to the study.
The participants (47 percent of whom were women) had an average age of nearly 53 years at baseline and an average body mass index (BMI) of 32. At month 15, the average ±SE (plus or minus standard error) change in BMI from baseline was -2.2 (±0.3) in the coach-led group,-1.6 (±0.3) in the self-directed group and -0.9(±0.3) in the usual care group. The percentage of participants who reached the 7 percent DPP-based weight-loss goal were 37 percent and 35.9 percent in the coach-led and self-directed groups, respectively, compared with 14.4 percent in the usual care group. Compared with the usual care group, improvements reached "statistical significance" for waist circumference and fasting plasma glucose levels in both interventions, according to the study results.
"The E-LITE trial makes a unique contribution to this growing literature in that its interventions integrate standardized, packaged DPP translational programs (delivered in groups or by DVD) with existing health IT [information technology]," the authors conclude. "Although these intervention components and delivery channels are not new, their integration into structured interventions for use in primary care is novel."
(Arch Intern Med. Published online December 10, 2012. doi:10.1001/2013/jamainternmed.987.)
Editor's Note: The E-LITE study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases, a Scientist Development Grant award from the American Heart Association and internal funding from the Palo Alto Medical Foundation Research Institute. One author also acknowledged support and another has provided consulting services to a pharmaceutical company. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
###
To contact author Jun Ma, M.D., Ph.D., call Cynthia Greaves at 650-934-8616 or 650-444-3019 or email greavec@pamf.org.
Diabetes prevention program interventions lead to reduced BMI over usual care
2012-12-11
ELSE PRESS RELEASES FROM THIS DATE:
Point-of-care ultrasound is more accurate than the stethoscope in diagnosing pneumonia in children
2012-12-11
Point-of-care ultrasound is more accurate than the traditional method of auscultation by stethoscope in diagnosing pneumonia in children and young adults, and can even detect small pneumonias that a chest x-ray may miss, a Mount Sinai researcher reports in an article titled, "Prospective Evaluation of Point-of-Care Ultrasonography for the Diagnosis of Pneumonia in Children and Young Adults" in the online edition of Archives of Pediatrics & Adolescent Medicine published December 10, 2012.
These findings have important public health implications, especially in the developing ...
Tobacco smuggling in Europe lower than industry figures suggest
2012-12-11
The prevalence of tobacco smuggling in Europe is lower than industry figures suggest, reveals the largest study of its kind, published online in Tobacco Control.
Significantly, it is availability, rather than price, that seems to determine the level of illicit trade, the research suggests a finding that runs directly counter to the arguments proffered by the tobacco industry say the authors.They base their findings on a representative population sample of 1000 people from each of 18 European countries: Albania; Austria; Bulgaria; Czech Republic; Croatia; England; Finland; ...
Feeling lonely linked to increased risk of dementia in later life
2012-12-11
Feeling lonely, as distinct from being/living alone, is linked to an increased risk of developing dementia in later life, indicates research published online in the Journal of Neurology Neurosurgery and Psychiatry.
Various factors are known to be linked to the development of Alzheimer's disease, including older age, underlying medical conditions, genes, impaired cognition, and depression, say the authors.
But the potential impacts of loneliness and social isolation—defined as living alone, not having a partner/spouse, and having few friends and social interactions — ...
Pre-diabetic patients respond to self-directed lifestyle interventions, Stanford researcher says
2012-12-11
STANFORD, Calif. — Efforts to help overweight patients avoid diabetes through lifestyle changes need not rely on intensive, one-on-one focused programs, a new clinical study from the Stanford University School of Medicine and the Palo Alto Medical Foundation Research Institute has found.
The study, to be published Dec. 10 in the Archives of Internal Medicine, opens up a practical way for primary care physicians to help their patients at high risk for developing diabetes.
Researchers have known for 10 years that intensive intervention programs led by lifestyle coaches ...
Educational video helps terminal cancer patients decide whether to receive CPR
2012-12-11
Patients with terminal cancer who viewed a three-minute video demonstrating cardiopulmonary resuscitation (CPR) were less likely to indicate a preference for receiving CPR in the event of an in-hospital cardiac arrest than were patients who only listened to a verbal description of the procedure. The study that will appear in the Journal of Clinical Oncology and is being released online today is a follow-up to a smaller, 2009 study and includes a more diverse group of patients with many forms of cancer.
"It really is incumbent on us, as physicians, to help our patients ...
Inspiration from a porcupine's quills
2012-12-11
CAMBRIDGE, MA -- Anyone unfortunate enough to encounter a porcupine's quills knows that once they go in, they are extremely difficult to remove. Researchers at MIT and Brigham and Women's Hospital now hope to exploit the porcupine quill's unique properties to develop new types of adhesives, needles and other medical devices.
In a new study, the researchers characterized, for the first time, the forces needed for quills to enter and exit the skin. They also created artificial devices with the same mechanical features as the quills, raising the possibility of designing ...
Mayo Clinic researchers uncover toxic interaction in neurons that leads to dementia and ALS
2012-12-11
JACKSONVILLE, Fla. — Researchers at Mayo Clinic in Florida have uncovered a toxic cellular process by which a protein that maintains the health of neurons becomes deficient and can lead to dementia. The findings shed new light on the link between culprits implicated in two devastating neurological diseases: END ...
Caffeinated coffee linked to lower risk of some oral cancers
2012-12-11
ATLANTA – December 10, 2012—A new American Cancer Society study finds a strong inverse association between caffeinated coffee intake and oral/pharyngeal cancer mortality. The authors say people who drank more than four cups of caffeinated coffee per day were at about half the risk of death of these often fatal cancers compared to those who only occasionally or who never drank coffee. The study is published online in the American Journal of Epidemiology. The authors say more research is needed to elucidate the biologic mechanisms that could be at work.
Previous epidemiologic ...
'Commitment-phobic' adults could have mom and dad to blame
2012-12-11
Afraid to commit to a relationship? According to new research from Tel Aviv University, it could be just one more thing to blame on your parents.
A study of the romantic history of 58 adults aged 22-28 found that those who avoid committed romantic relationships are likely a product of unresponsive or over-intrusive parenting, says Dr. Sharon Dekel, a psychologist and researcher at the Bob Shappell School of Social Work.
Dr. Dekel and her fellow researcher, Prof. Barry Farber of Columbia University, found that 22.4 percent of study participants could be categorized ...
Do we live in a computer simulation? Researchers say idea can be tested
2012-12-11
A decade ago, a British philosopher put forth the notion that the universe we live in might in fact be a computer simulation run by our descendants. While that seems far-fetched, perhaps even incomprehensible, a team of physicists at the University of Washington has come up with a potential test to see if the idea holds water.
The concept that current humanity could possibly be living in a computer simulation comes from a 2003 paper published in Philosophical Quarterly by Nick Bostrom, a philosophy professor at the University of Oxford. In the paper, he argued that ...