Objective: This systematic review aimed to establish a specific evidence-base of diabetes prevention programs for adults at high risk of developing type 2 diabetes (T2D) based on either the Diabetes Prevention Program (DPP) or the Finnish Diabetes Prevention Study (DPS).
Methods: The bibliographic databases: Medline, Ovid, Embase, CINAHL, Scopus, Web of Science, Joanna Brigg Institute Library, Cochrane Central Register of Controlled Trials, and grey literature were searched for published articles in the English language from January 1996 to December 2018. This review included only RCTs conducted in community settings focusing on adults at high risk of T2D, utilizing an intervention based on either the DPP or DPS and measuring the incidence of T2D as an outcome.
Results: Of 4,964 identified records, eight studies met all inclusion criteria and were suitable for meta-analysis. The meta-analysis revealed positive effects of programs based on either DPP or DPS on prevention T2D in adults at high risk. The pooled incidence rate of T2D in the intervention group was 47% lower than those in the control group (95% CI 9%, 69%). Attending lifestyle change program achieved a pooled mean weight loss of 2.10 kg (95% CI -3.45, -0.74) which was significantly higher than those of the control group. Data in physical activity, dietary and HbA1c were not commonly reported. Although the feasibility of the prevention program was established, this review found a lack of data in enablers and barriers in implementing a diabetes prevention program.
Conclusion: The effectiveness of T2D prevention program based on either the DPP or DPS delivered in community settings is evidenced, and the reduction in cumulative incidence of T2D was reported. Nonetheless, further research on enables and barriers associated with increasing physical activity and improving healthy eating is warranted to help sustain the optimal outcomes of the pragmatic diabetes prevention program.
K.H. Wechkunanukul: None. F. Benton: None. J. McGill: None. S. Ullah: None.