Nested Pilot Study Comparing Two Treatments to Reduce Type 2 Diabetes Risk in At-Risk Delawareans

February 26, 2026 updated by: Freda Patterson, University of Delaware
This nested pilot Randomized Clinical Trial will determine whether the Diabetes Prevention Program (DPP) enhanced with evidence-based sleep health and time restricted eating interventions ("DPP++") is more effective than the DPP alone for improving metabolic and cardiovascular metrics in 40 overweight/obese adults with prediabetes.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Prediabetes affects over one-third of Delaware residents, placing more than 70% at risk of developing type 2 diabetes (T2D) within a decade if left untreated. This public health burden disproportionately impacts diverse population segments, including racial/ethnic minority groups and those with lower income and education; groups who are less likely to benefit from current prevention strategies. The 12-month National Diabetes Prevention Program (DPP) is the first-line intervention to prevent T2D, but only 35% of participants achieve the recommended ≥5% weight loss, with non-responders more likely to reside in high-priority communities. Moreover, comorbid conditions such as hypertension remain inadequately addressed. Sleep health improvements and time-restricted eating (TRE) are two promising, evidence-based strategies shown to enhance metabolic and cardiovascular outcomes. Despite recommendations from national guidelines for diabetes prevention and management to include sleep health, their widespread implementation is limited by the lack of an effective delivery platform. Expanding the DPP to include these interventions (creating the "DPP++"; DPP + sleep health + TRE) could provide a scalable solution to enhance efficacy and improve access to diabetes prevention across all communities. This 12-month Clinical and Translational Research (CTR) pilot study will evaluate the clinical efficacy of DPP++ compared to the standard DPP among adults at risk for T2D already enrolled in DPP cohorts administered by the University of Delaware Nutrition Clinic. Focused community-engagement efforts that are overseen by the study steering committee will target traditionally overlooked populations to enroll in these cohorts. Between months 1-3 of the standard DPP, participants will be invited to join a nested randomized controlled trial. In month 4, consenting participants will be randomized to either the standard DPP (control) or DPP++. Aim 1 of this study will compare the efficacy of DPP++ vs. standard DPP on metabolic health at 6 and 12 months. Aim 2 will assess DPP++ vs. standard DPP differences in cardiovascular health and quality of life. Completing this pilot will also support the capacity for integrating the sleep health and TRE intervention components into clinical practice.

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Freda Patterson, PhD
  • Phone Number: 302-831-6588
  • Email: fredap@udel.edu

Study Locations

  • United States
    • Delaware
      • Newark, Delaware, United States, 19713
        • Recruiting
        • Nutrition Clinic, University of Delaware

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 years or older
  • Prediabetes confirmed by blood test result within 12 months of enrollment, previous diagnosis of gestational diabetes mellitus (GDM), or positive screening for prediabetes based on the Prediabetes Risk Test
  • BMI of 25 kg/m² or greater (23 kg/m² or greater for Asian Americans)

Exclusion Criteria:

  • Age younger than 18 years
  • BMI less than 25 kg/m² (less than 23 kg/m² for Asian Americans)
  • No current diagnosis of prediabetes or gestational diabetes mellitus
  • Prior diagnosis of type 1 or type 2 diabetes
  • Pregnancy at the time of enrollment
  • Development of a medical condition that, in the PI's judgment, could be exacerbated by the study interventions (e.g., eating disorder, severe sleep disorder)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Standard Diabetes Prevention Program (DPP Control)
Participants continue with the standard 12-month National Diabetes Prevention Program (DPP) as delivered by the University of Delaware Nutrition Clinic. The DPP is a 26-session, group-based lifestyle intervention focusing on healthy eating, increased physical activity, and behavior change strategies, with a primary goal of achieving 5-7% weight loss and 150 minutes of moderate-to-vigorous physical activity per week. Sessions are delivered weekly in months 1-4, bi-weekly in months 5-6, and monthly in months 7-12.
Behavioral: National Diabetes Prevention Program (DPP)
A 12-month, 26-session group-based lifestyle intervention delivered by trained lifestyle coaches focusing on healthy eating, physical activity, stress management, and behavior change strategies. The primary goal is to achieve 5-7% weight loss and 150 minutes of moderate-to-vigorous physical activity per week. Sessions are delivered weekly in months 1-4, bi-weekly in months 5-6, and monthly in months 7-12.
Experimental: Enhanced Diabetes Prevention Program (DPP++)
Participants receive the standard 12-month DPP plus two additional evidence-based components delivered in months 5-6: (1) a sleep health digital application delivering self-guided behavioral strategies to improve sleep, and (2) a time-restricted eating intervention. Educational materials and a brief orientation session are provided at the time of randomization to support engagement with both added components.
Behavioral: National Diabetes Prevention Program (DPP)
A 12-month, 26-session group-based lifestyle intervention delivered by trained lifestyle coaches focusing on healthy eating, physical activity, stress management, and behavior change strategies. The primary goal is to achieve 5-7% weight loss and 150 minutes of moderate-to-vigorous physical activity per week. Sessions are delivered weekly in months 1-4, bi-weekly in months 5-6, and monthly in months 7-12.
Behavioral: Sleep Health Digital Application
A self-guided digital sleep health program delivering evidence-based behavioral strategies to improve sleep duration, timing, and quality. Participants have access to the application during months 5-12 of the study.
Behavioral: Time-Restricted Eating (TRE)
A self-guided intervention targeting eating window. Participants receive educational materials and a brief orientation session at randomization to support implementation and adherence.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percent weight loss
Time Frame: Baseline to 6 months
Percent weight loss from baseline, calculated from body weight measured at baseline and the primary endpoint (month 6). Between-group differences in percent weight loss will be compared between the experimental DPP++ and control DPP arms.
Baseline to 6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Delaware

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2026

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

June 1, 2027

Study Registration Dates

First Submitted

February 26, 2026

First Submitted That Met QC Criteria

February 26, 2026

First Posted (Actual)

March 4, 2026

Study Record Updates

Last Update Posted (Actual)

March 4, 2026

Last Update Submitted That Met QC Criteria

February 26, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2355212

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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