631-P: Effectiveness of Freedom from Diabetes Protocol in Managing Prediabetes in Indian Population—A Quasi-experimental Study

Introduction: Prediabetes, a crucial metabolic state, significantly increases the risk of type 2 diabetes (T2D). India's surging prediabetes cases outpace those of diabetes, highlighting an impending T2D crisis. Urgent attention and effective management strategies are crucial.

Aim: To assess the effectiveness of a one-year online lifestyle intervention program in prediabetes patients, while exploring gender-specific and BMI-based differences in outcomes.

Methods: This study analyzed data from 715 patients with prediabetes (HbA1c: 5.7%-6.4%; not on insulin or OHAs, aged >18 years) attending a one-year online lifestyle intervention program at the Freedom from Diabetes Clinic, India. The intervention consisted of personalized plant-based diet, physical activity, stress management, and medical management. The baseline and end-line assessments included anthropometric and biochemical parameters.

Results: The study population, consisting of 60% females and a mean age of 50.6±10 years, exhibited a median HbA1c of 6.0% (5.8-6.2). Post-intervention, a substantial reduction in HbA1c (<5.7%) and BMI (<25 kg/m²) was observed in 56% and 16.1% of patients, respectively (p<0.05). Women showed greater improvements in weight loss, BMI, fasting insulin, and HOMA-IR than men (p<0.05). Patients with a BMI greater than 25 kg/m² showed greater weight loss (kg) (-6.7 vs. -1.8) and improvements in total cholesterol, triglycerides, and non-HDL compared to those with a BMI less than 25 kg/m² (p<0.05). In both BMI categories, the improvement in HbA1c levels was comparable (p>0.1) and weight loss was positively correlated with HbA1c drop (p<0.01).

Conclusion: Women with prediabetes showed better outcomes in response to the lifestyle interventions than men. Weight loss relative to BMI improved the glycemic profile of both obese and non-obese patients. Comprehensive lifestyle interventions may serve as effective strategies for managing prediabetes.