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Challenges of diabetes prevention in the real world : results and lessons from the Melbourne diabetes prevention study

Dunbar, James A., Hernan, Andrea L., Janus, Edward D., Vartiainen, Erkki, Laatikainen, Tiina, Versace, Vincent L., Reynolds, John, Best, James D., Skinner, Timothy C., O'Reilly, Sharleen L., Mc Namara, Kevin P., Stewart, Elizabeth, Coates, Michael, Bennett, Catherine M. and Carter, Rob 2015, Challenges of diabetes prevention in the real world : results and lessons from the Melbourne diabetes prevention study, BMJ open diabetes research and care, vol. 3, no. 1, pp. 1-13, doi: 10.1136/bmjdrc-2015-000131.

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Title Challenges of diabetes prevention in the real world : results and lessons from the Melbourne diabetes prevention study
Author(s) Dunbar, James A.ORCID iD for Dunbar, James A. orcid.org/0000-0003-0866-4365
Hernan, Andrea L.ORCID iD for Hernan, Andrea L. orcid.org/0000-0003-4542-1186
Janus, Edward D.
Vartiainen, Erkki
Laatikainen, Tiina
Versace, Vincent L.ORCID iD for Versace, Vincent L. orcid.org/0000-0002-8514-1763
Reynolds, John
Best, James D.
Skinner, Timothy C.
O'Reilly, Sharleen L.ORCID iD for O'Reilly, Sharleen L. orcid.org/0000-0003-3547-6634
Mc Namara, Kevin P.ORCID iD for Mc Namara, Kevin P. orcid.org/0000-0001-6547-9153
Stewart, Elizabeth
Coates, Michael
Bennett, Catherine M.ORCID iD for Bennett, Catherine M. orcid.org/0000-0001-9581-1612
Carter, RobORCID iD for Carter, Rob orcid.org/0000-0002-1586-5619
Journal name BMJ open diabetes research and care
Volume number 3
Issue number 1
Start page 1
End page 13
Total pages 13
Publisher BMJ Publishing Group
Place of publication London, Eng.
Publication date 2015
ISSN 2052-4897
Keyword(s) Cardiovascular Prevention
Intervention
Public Health
Type 2 Diabetes
Summary OBJECTIVE: To assess effectiveness and implementability of the public health programme Life! Taking action on diabetes in Australian people at risk of developing type 2 diabetes.

RESEARCH DESIGN AND METHODS: Melbourne Diabetes Prevention Study (MDPS) was a unique study assessing effectiveness of Life! that used a randomized controlled trial design. Intervention participants with AUSDRISK score ≥15 received 1 individual and 5 structured 90 min group sessions. Controls received usual care. Outcome measures were obtained for all participants at baseline and 12 months and, additionally, for intervention participants at 3 months. Per protocol set (PPS) and intention to treat (ITT) analyses were performed.

RESULTS: PPS analyses were considered more informative from our study. In PPS analyses, intervention participants significantly improved in weight (-1.13 kg, p=0.016), waist circumference (-1.35 cm, p=0.044), systolic (-5.2 mm Hg, p=0.028) and diastolic blood pressure (-3.2 mm Hg, p=0.030) compared with controls. Based on observed weight change, estimated risk of developing diabetes reduced by 9.6% in the intervention and increased by 3.3% in control participants. Absolute 5-year cardiovascular disease (CVD) risk reduced significantly for intervention participants by 0.97 percentage points from 9.35% (10.4% relative risk reduction). In control participants, the risk increased by 0.11 percentage points (1.3% relative risk increase). The net effect for the change in CVD risk was -1.08 percentage points of absolute risk (p=0.013).

CONCLUSIONS: MDPS effectively reduced the risk of diabetes and CVD, but the intervention effect on weight and waist reduction was modest due to the challenges in recruiting high-risk individuals and the abbreviated intervention.
Language eng
DOI 10.1136/bmjdrc-2015-000131
Field of Research 111716 Preventive Medicine
Socio Economic Objective 920104 Diabetes
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2015, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30079360

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.