The type 2 diabetes 'modern preventable pandemic' and replicable lessons from the COVID-19 crisis

To frame the substantial prevalence of type 2 diabetes (T2D) as a ‘Modern Preventable Pandemic’ (MPP) and present certain replicable policy lessons from the COVID-19 crisis to address it. A literature and policy review was performed to analyze data about the COVID-19 and T2D pandemics to establish their multi-factorial health, social, and economic impacts. With the global prevalence of T2D tripling in the last two decades, T2D has become an MPP largely due to modifiable human behaviors. Certain successful elements of the response to the COVID-19 pandemic provide important lessons that can be adapted for the growing T2D MPP. With proper education and access to resources, it is possible to mitigate the T2D MPP through focused government policies as illustrated by many of the lessons of the COVID-19 pandemic response. Without such government intervention, the T2D MPP will continue to grow at an unsustainable pace with enormous health, social and economic implications. Immediate action is necessary. The scale of the T2D pandemic warrants a robust response in health policy as outlined through eight coordinated efforts; the lessons of the COVID-19 crisis should be studied and applied to the T2D MPP.

Comparison between volunteer- and expert-led versions of a community-based weight-loss intervention

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We compared the effects of volunteer- and expert-led weight-loss intervention.

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Participants were instructed to maintain a well-balanced, low-energy diet.

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The completion proportions was significantly higher in the expert-led group.

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The degree of body weight change was similar for both groups.

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Such programs could be an alternative strategy for low-cost obesity management.

This study compared the effect of volunteer- and expert-led versions of a community-based weight-loss intervention in a non-randomized comparative trial conducted in Ibaraki, Japan from 2016 to 2017. Participants were 145 Japanese adults with overweightness or obesity, aged 20–69 years, with 77 in a volunteer-led group and 68 in an expert-led group. Both groups received the same program content and intervention period. Community volunteers were trained in four or five 3-hour training sessions while experts were highly trained and experienced professionals in the fields of exercise and nutrition prescription. Participants were also instructed to maintain a well-balanced, low-energy diet. The primary outcome measure was body weight change. In the volunteer- and expert-led groups, 58 of 77 (75%) and 61 of 68 (95%) participants completed the 12-week intervention, respectively. The mean (95% confidence interval, CI) weight loss of the volunteer-led group was 6.4 (95% CI: 5.6–7.2) kg, corresponding to 8.9% of initial body weight, while that of the expert-led group was 6.3 (95% CI: 5.5–7.1) kg, corresponding to 8.2% of the initial body weight. The proportion of participants who completed the course was significantly higher in the expert-led group (P < 0.05); however, the degree of the body weight change was similar for both groups. With improvement in the completion proportion of the volunteer-led weight-loss interventions, such programs could be an alternative strategy for the wide-scale dissemination of low-cost obesity management.

Filipinos Fit and Trim - A feasible and efficacious DPP-based intervention trial

INTRODUCTION

Filipino Americans are at higher risk for obesity and related Type 2 diabetes (T2D) compared to other Asian subgroups and non-Hispanic whites. Yet, there are limited research studies to reduce health disparities and improve health outcomes for Filipinos. Weight loss lifestyle intervention trials such as the Diabetes Prevention Program (DPP) can reduce obesity and T2D risks through physical activity and healthy eating.

METHODS

Thus, we conducted a pilot Fit&Trim (DPP-based) intervention study - a randomized controlled trial 3-month intervention augmented with mobile technology + 3-month maintenance follow-up with a waitlist control. The objective assessed the intervention feasibility and potential efficacy to reduce T2D risks in Filipino Americans with overweight/obesity. The overall study goal was a mean 5% weight reduction.

RESULTS

Sixty-seven eligible Filipino men and women were enrolled and randomized to either an intervention or waitlist control group. Participant retention was 91%. In Phase 1 (baseline to 3-months), the intervention group had greater weight reduction compared to the waitlist control (-4.3% vs. -0.88%; cross-level interaction = -0.85 (-1.4, -0.35). In Phase 2 (3- to 6-months), after receiving the Fit&Trim intervention, the waitlist group also had similar significant weight reduction [-4.8% (- 0.75 (-0.92, -0.58)]. A majority of intervention group (57%) also maintained their weight loss. Overall, 41% of study participants achieved a 5% weight loss.

CONCLUSION

The Fit&Trim intervention demonstrated feasibility and potential efficacy for Filipino Americans. Findings warrant a further larger, longer trial to test the Fit&Trim feasibility and effectiveness in a real-world Filipino community setting.

CLINICALTRIALSGOV REGISTRATION NUMBER

NCT02278939.