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An Outpatient-Based Clinical Program for Diabetes Prevention: An Update.
MedLine Citation:
PMID:  22068253     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: Update outcomes of Diet-Exercise-Activity-Lifestyle (DEAL) program, a clinic-based diabetes prevention intervention.Methods: Changes in weight, fasting glucose, and 2-hour glucose after 75-g oral glucose tolerance test were evaluated for patients with DEAL enrollment between January 2007 and August 2009.Results: Mean age of the 221 qualified participants was 62 years; weight, 87.4 kg; body mass index, 31.2 kg/m2; fasting glucose, 109 mg/dL; and 2-hour glucose, 138 mg/dL. Among participants, 67% were women and 89% were white; 56% had isolated impaired fasting glucose, 5% had impaired glucose tolerance, and 39% had both. The 6-month follow-up appointment was kept by 72%, but 56% attended the 12-month visit. By 6 months after baseline, 59% had lower fasting glucose levels (from 110 mg/L to 103 mg/dL; P<.001); 59%, improvement in 2-hour glucose (from 147 mg/dL to 115 mg/dL; P<.001), and 61%, weight loss (from 87.7 kg to 84.2 kg; P<.001). However, 36%, 40%, and 38%, respectively, had significantly increased fasting glucose, 2-hour glucose, and weight by 6 months (P<.001 for all). Significant declines in fasting glucose, 2-hour glucose, and weight occurred by the 12-month visit compared with baseline values (P<.01 for all); however, no significant changes occurred in these measures between 6- and 12-month visits (P>.30 for all).Conclusions: Most DEAL participants showed improvement in glucose levels and weight, but some exhibited worsening glucose intolerance. Factors underlying nonresponse need to be identified. Ongoing experience and analysis should permit revisions to DEAL so that outcomes for all patients participating in the program will improve.
Authors:
Christine M Swanson; Sophie Bersoux; Marcia H Larson; Ruth T Aponte-Furlow; Sandra S Flatten; Cari L Olsen; Carolyn Larosa; Patricia M Verona; Kimberly A Jameson; Curtiss B Cook
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-8
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  -     ISSN:  1934-2403     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-26     Citation Subset:  -    
Affiliation:
Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona.
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