A Randomized Controlled Trial Translating the Diabetes Prevention Program to a University Worksite, Ohio, 2012-2014

Kellie R Weinhold, Carla K Miller, David G Marrero, Haikady N Nagaraja, Brian C Focht, Gregg M Gascon, Kellie R Weinhold, Carla K Miller, David G Marrero, Haikady N Nagaraja, Brian C Focht, Gregg M Gascon

Abstract

Introduction: Working adults spend much time at the workplace, an ideal setting for wellness programs targeting weight loss and disease prevention. Few randomized trials have evaluated the efficacy of worksite diabetes prevention programs. This study evaluated the efficacy of a worksite lifestyle intervention on metabolic and behavioral risk factors compared with usual care.

Methods: A pretest-posttest control group design with 3-month follow-up was used. Participants with prediabetes were recruited from a university worksite and randomized to receive a 16-week lifestyle intervention (n = 35) or usual care (n = 34). Participants were evaluated at baseline, postintervention, and 3-month follow-up. Dietary intake was measured by a food frequency questionnaire and level of physical activity by accelerometers. Repeated measures analysis of variance compared the change in outcomes between and within groups.

Results: Mean (standard error [SE]) weight loss was greater in the intervention (-5.5% [0.6%]) than in the control (-0.4% [0.5%]) group (P < .001) postintervention and was sustained at 3-month follow-up (P < .001). Mean (SE) reductions in fasting glucose were greater in the intervention (-8.6 [1.6] mg/dL) than in the control (-3.7 [1.6] mg/dL) group (P = .02) postintervention; both groups had significant glucose reductions at 3-month follow-up (P < .001). In the intervention group, the intake of total energy and the percentage of energy from all fats, saturated fats, and trans fats decreased, and the intake of dietary fiber increased (all P < .01) postintervention.

Conclusion: The worksite intervention improved metabolic and behavioral risk factors among employees with prediabetes. The long-term impact on diabetes prevention and program sustainability warrant further investigation.

Trial registration: ClinicalTrials.gov NCT01682954.

Figures

Figure
Figure
Phases of the randomized controlled trial for the intervention and usual care (control) groups in a university worksite diabetes prevention study, Ohio, 2012–2014.

References

    1. Bullard KM, Saydah SH, Imperatore G, Cowie CC, Gregg EW, Geiss LS, et al. Secular changes in U.S. prediabetes prevalence defined by hemoglobin A1c and fasting plasma glucose: National Health and Nutrition Examination Surveys, 1999–2010. Diabetes Care 2013;36(8):2286–93. 10.2337/dc12-2563
    1. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet 2012;379(9833):2279–90. 10.1016/S0140-6736(12)60283-9
    1. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393–403. 10.1056/NEJMoa012512
    1. Pan XR, Li GW, Hu YH, Wang JX, Yang WY, An ZX, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20(4):537–44. 10.2337/diacare.20.4.537
    1. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344(18):1343–50. 10.1056/NEJM200105033441801
    1. Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, Brenneman AT, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009;374(9702):1677–86. 10.1016/S0140-6736(09)61457-4
    1. Schröer S, Haupt J, Pieper C. Evidence-based lifestyle interventions in the workplace — an overview. Occup Med (Lond) 2014;64(1):8–12. 10.1093/occmed/kqt136
    1. Goetzel RZ, Pei X, Tabrizi MJ, Henke RM, Kowlessar N, Nelson CF, et al. Ten modifiable health risk factors are linked to more than one-fifth of employer-employee health care spending. Health Aff (Millwood) 2012;31(11):2474–84. 10.1377/hlthaff.2011.0819
    1. Jackson L. Translating the Diabetes Prevention Program into practice: a review of community interventions. Diabetes Educ 2009;35(2):309–20. 10.1177/0145721708330153
    1. Barham K, West S, Trief P, Morrow C, Wade M, Weinstock RS. Diabetes prevention and control in the workplace: a pilot project for county employees. J Public Health Manag Pract 2011;17(3):233–41. 10.1097/PHH.0b013e3181fd4cf6
    1. Giese KK, Cook PF. Reducing obesity among employees of a manufacturing plant: translating the Diabetes Prevention Program to the workplace. Workplace Health Saf 2014;62(4):136–41. 10.3928/21650799-20140305-02
    1. Aldana S, Barlow M, Smith R, Yanowitz F, Adams T, Loveday L, et al. A worksite diabetes prevention program: two-year impact on employee health. AAOHN J 2006;54(9):389–95. 10.1177/216507990605400902
    1. Wilson MG, DeJoy DM, Vandenberg R, Padilla H, Davis M. FUEL your life: a translation of the Diabetes Prevention Program to worksites. Am J Health Promot 2015. 10.4278/ajhp.130411-QUAN-169
    1. Are you at risk for type 2 diabetes? Diabetes risk test. American Diabetes Association; 2015. . Accessed June 18, 2015.
    1. American Diabetes Association. (2) Classification and diagnosis of diabetes. Diabetes Care 2015;38(Suppl):S8–16.10.2337/dc15-S005
    1. Thomas S, Reading J, Shephard RJ. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can J Sport Sci 1992;17(4):338–45.
    1. Diabetes Prevention Program curriculum. Atlanta (GA): Centers for Disease Control and Prevention (CDC): National Center for Chronic Disease Prevention and Health Promotion, Division of Diabetes Translation; 2012. . Accessed November 19, 2014.
    1. Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care 2002;25(12):2165–71. 10.2337/diacare.25.12.2165
    1. Sacks FM, Bray GA, Carey VJ, Smith SR, Ryan DH, Anton SD, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009;360(9):859–73. 10.1056/NEJMoa0804748
    1. National Diabetes Education Program. Small steps. Big rewards. Your game plan to prevent type 2 diabetes. . Accessed August 20, 2014.
    1. Ackermann RT, Finch EA, Brizendine E, Zhou H, Marrero DG. Translating the Diabetes Prevention Program into the community: the DEPLOY pilot study. Am J Prev Med 2008;35(4):357–63. 10.1016/j.amepre.2008.06.035
    1. National Health and Nutrition Examination Survey Examination: anthropometry procedures manual. Hyattsville (MD): Centers for Disease Control and Prevention, National Center for Health Statistics; 2011. . Accessed August 20, 2014.
    1. Alere. Alere Cholestech LDX System. . Accessed August 20, 2014.
    1. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18(6):499–502.
    1. Omron Healthcare, Inc. Validation standards and testing for blood pressure monitors. . Accessed August 20, 2014.
    1. Maruthur NM, Ma Y, Delahanty LM, Nelson JA, Aroda V, White NH, et al. Early response to preventive strategies in the Diabetes Prevention Program. J Gen Intern Med 2013;28(12):1629–36. 10.1007/s11606-013-2548-4
    1. Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation 2014;129(25 Suppl 2):S102–38. Erratum in Circulation 2014;129(25 Suppl 2):S139–40. 10.1161/
    1. Rolando L, Byrne DW, McGown PW, Goetzel RZ, Elasy TA, Yarbrough MI. Health risk factor modification predicts incidence of diabetes in an employee population: results of an 8-year longitudinal cohort study. J Occup Environ Med 2013;55(4):410–5. 10.1097/JOM.0b013e31827cbaec
    1. Wing RR, Venditti E, Jakicic JM, Polley BA, Lang W. Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 1998;21(3):350–9. 10.2337/diacare.21.3.350
    1. Wing RR, Hamman RF, Bray GA, Delahanty L, Edelstein SL, Hill JO, et al. Achieving weight and activity goals among Diabetes Prevention Program lifestyle participants. Obes Res 2004;12(9):1426–34. 10.1038/oby.2004.179
    1. Conn VS, Hafdahl AR, Mehr DR. Interventions to increase physical activity among healthy adults: meta-analysis of outcomes. Am J Public Health 2011;101(4):751–8. 10.2105/AJPH.2010.194381
    1. Jaacks LM, Ma Y, Davis N, Delahanty LM, Mayer-Davis EJ, Franks PW, et al. Long-term changes in dietary and food intake behaviour in the Diabetes Prevention Program Outcomes Study. Diabet Med 2014;31(12):1631–42. 10.1111/dme.12500
    1. Roumen C, Corpeleijn E, Feskens EJ, Mensink M, Saris WH, Blaak EE. Impact of 3-year lifestyle intervention on postprandial glucose metabolism: the SLIM study. Diabet Med 2008;25(5):597–605. 10.1111/j.1464-5491.2008.02417.x
    1. Leser MS, Yanovski SZ, Yanovski JA. A low-fat intake and greater activity level are associated with lower weight regain 3 years after completing a very-low-calorie diet. J Am Diet Assoc 2002;102(9):1252–6. 10.1016/S0002-8223(02)90277-4
    1. Morgan PJ, Callister R, Collins CE, Plotnikoff RC, Young MD, Berry N, et al. The SHED-IT community trial: a randomized controlled trial of internet- and paper-based weight loss programs tailored for overweight and obese men. Ann Behav Med 2013;45(2):139–52. 10.1007/s12160-012-9424-z

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir