Aim: Implementation of newer intervention strategies in Prediabetes (PDM) may delay the onset of DM. Aim was to see the effect of simple multi pronged approach in a real world situation to prevent progression to DM.

Methods: PDM subjects (n=220) were assigned into 2 groups(Gp) from Aug 2017 in a diabetes centre in Chennai, India. OGTT was done and diagnosis was by WHO criteria. PDM subjects; IFG, IGT, Elevated 1h PG, were assigned to control and intervention groups; (n=110 in each). Gp1 received standard care, Gp2 intensive counseling on physical activity (PA) and diet (reducing calories, carbohydrates, fat, increasing fibre). PA included walking for 150min/week and customized advice based on profession. Working subjects to avoid prolonged sitting at work place, using stairs in work areas, walking instead of hiring vehicles for short distances; Business professionals advised to walk in corridors during stay in hotels for business purpose; Housewives to do simple walks in balconies and terrace, to avoid electronic appliances. Subjects were followed up(FU) once in 6 months and repeated OGTT. Calls, mails and SMS used for FU. Those came for FU(n=91;47vs41) till Sep 2019 were included for interim analysis.

Results: Mean age of subjects was 44 years and duration of FU was 12.1 (range 4-28) months. There was a significant difference in conversion rate to DM. (Gp1 vs. 2;34 vs. 9.1%,p=0.004). The subjects who reverted back to normal was significantly higher in Gp 2 compared to Gp1 (31.8 vs. 10.6%;p =0.012). The survival curve showed mean survival time for Gp1 was 19.6 (95% CI 16.6-22.8) and Gp2 was 22.2 months (CI 19.9-24.4;p=0.014). In Gp2, there was a significant reduction in Wt, body fat (p=0.022), WHR(P=0.003), elevated 1 hr glucose (p=0.004) whereas in Gp1 reduction was observed only in glucose levels (p<0.001).

Conclusion: It was possible to prevent diabetes in subjects with prediabetes using multi-pronged intervention strategies in real world scenario.


V. Viswanathan: None. R. Parveen: None. P. Murugan: None. S. Kumpatla: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at