Community Awareness Programs Help Reduce Type 2 Diabetic Risk

Type 2 diabetes may be up to 95% preventable, though often major dietary, physical, and even social lifestyle changes are needed to achieve this end. A recent study has found that individuals who participate in community-based awareness programs are at lower risk for developing the disease, perhaps illuminating a more palpable way of preventing this dangerous condition.

According to the study, “more than 60 million Americans have prediabetes, defined by impaired glucose tolerance (IGT) or impaired fasting glucose (IFG).” This is a staggering number, and in addition to increased diabetic risk, these individuals face increased risk for related conditions, such as cardiovascular disease.

Awareness and the subsequent initiation of lifestyle changes are the two keys to preventing diabetes, but both are often difficult to achieve due to various circumstances (cost, individual motivation, organizational limitations, to name a few). Past research has shown that controlled and intensive individual awareness programs are helpful, but somewhat impractical on a large scale. These past programs (including the often referenced Diabetes Prevention Programs (DPP)) concluded that “structured diet and physical activity intervention achieving modest weight loss in overweight adults with IGT can significantly reduce the progression to diabetes,” but this current study suggests that these past programs “involved enrollment criteria and an intensive lifestyle intervention that are challenging to implement and sustain in busy healthcare settings.” Thus the current researchers aimed to see if more practical measures for intervention and prevention programs could be achieved through the community.

This study focused principally on the YMCA, due to their established wide-reaching capabilities, though the conclusions are meant to apply to other community-based organizations. More specifically, “this pilot study was conducted to test the hypotheses that YMCA wellness instructors could be trained to implement a group-based lifestyle intervention with fidelity to the DPP model and that adults at high risk for developing diabetes who were assigned to receive this intervention could achieve changes in body weight comparable to the DPP,” state the researchers.

Participants in the study were to meet four conditions for prediabetes for selection. These were determined in the following way: “(1) an invitation to adults with diabetes risk factors to attend a community-based screening and education event at the YMCA; (2) a determination of BMI; (3) completion of the 7-item American Diabetes Association (ADA) diabetes risk assessment; and (4) collection of a drop of whole blood by finger stick to assess casual capillary blood glucose (CCBG) concentration for people with a BMI ≥24 kg/m2 and an ADA risk score ≥10.”

92 individuals met the required criteria, and were split into an intervention group of 46 participants, and a control group of 46 participants. “Standard advice” concerning diabetes was distributed to both groups, but the intervention groups also participated in 16 “classroom-style meetings focused on building knowledge and skills for goal setting, self-monitoring, and problem-solving.” The 46 intervention individuals were further separated into groups of 8-12 for the meetings. Each meeting lasted between 60-90 minutes, and the program lasted between 16-20 weeks in total.

Follow-up visits were made by each participant 4-6 months after the conclusion of the intervention program. The most identifiable observation was that body weight decreased by approximately 6% over this time in intervention program participants, and approximately 2% in the control group participants. Excess body weight is a leading contributor to prediabetes and subsequent full-blown diabetes, so these are significant reductions to diabetic risk.

While the main purpose of this study is to indicate that community-based intervention programs are extremely effective in reducing diabetic risk (as indicated by the 6% body weight reduction at follow-up), it should also be noted that the 2% reduction in body weight following the simple dissemination of information is significant as well. Awareness followed by action is crucial, and the more intensively these strategies are followed, the more effective they will be.

Source: Defeat Diabetes Foundation: Ackerman, Ronald. Finch, Emily. Marrero, David. et al. American Journal of Preventative Medicine. “Translating the Diabetes Prevention Program into the Community The DEPLOY Pilot Study.” October 2008.

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