900-P: Long-Term Effectiveness of a DPP for Prediabetic Hispanic Women

The prevalence of type 2 diabetes(T2DM) in Hispanic Americans, at 22.6%, is twice that of non-hispanic whites. The NIDDK Diabetes Prevention Program (DPP) showed that an intensive lifestyle intervention can reduce the incidence of T2DM by 58% in many ethnic/racial groups. The DPP at Fair Haven Community Heath Care (FHCHC) in New Haven, CT is a modified NIDDK/CDC DPP which aims to promote weight loss, physical activity and reduced incidence of T2DM among Hispanic patients. A previous randomized controlled study showed that female participants in this DPP benefited with decreased weight, lower glucose excursions and improved fasting insulin one year after enrolling compared to controls. The purpose of this follow-up study is to assess the long-term effectiveness of the FHCHC DPP.

Methods: This study took place at FHCHC after obtaining IRB approval. A retrospective chart review was conducted comparing participants randomly assigned to the DPP with those assigned to control group. Measures abstracted included fasting glucose, 2-hour OGTT, HbA1c, lipids, blood pressure, BMI and medications from all medical visits between the date of enrollment and October 2018.

Results: All 66/66 original subjects in the DPP intervention group as well as 66/66 controls had clinical data beyond 1 year. An average of over 7 years follow-up was available for analysis. ANCOVA test comparing change of weight from baseline to specific time periods showed a significant difference between groups in change from baseline to year 1 of 20.86 lbs. (p=.001), change to year 2 and 3 of 13.8 lbs. (p=.004), but not year 4 and 5 of 11.3 lbs. (p=.067) or year 6+ 10. 0 lbs. (p=.163). There was no statistically significant difference between the two groups in fasting glucose, two-hour glucose tolerance test, or HbAlc.

Conclusion: Weight loss shown after 1 year of the FHCHC DPP was sustained at years 2 and 3 but not at years 4 through 7. HbA1C, two-hour glucose, and fasting glucose were not significantly different between groups after the first 1 year.