Diabetes Prevention Programs Produce Similar Results Regardless of Cost

A meta-analysis of several dozen studies has found that lifestyle intervention programs for those at high risk of diabetes resulted in moderate weight loss regardless of whether they were facilitated by high-cost clinically trained professionals or lower-cost lay educators.

Researchers from Emory University’s Rollins School of Public Health (RSPH) reviewed 28 US-based studies that applied the findings of the Diabetes Prevention Program (DPP) in real-world settings. The DPP, a clinical trial published in 2002, found that individuals with an increased risk for diabetes could reduce their progression to the condition by 58% through structured lifestyle programs.

“Participants in the DPP trial received exercise shoes, meal replacement shakes, personal (one-on-one) coaching by degree-holding professionals (exercise physiologists, nutritionists, nurses), and gym memberships that all together cost about $1,400 per person during the first year of the study,” said the current study’s lead investigator, Mohammed Ali, MBChB, assistant professor of global health at RSPH, in a press release.

Ali and his colleagues sought out studies that have attempted to achieve similar results at lower cost and compared their findings. Whereas moderate (5% to 7%) weight loss was the key to success in the DPP, the researchers found that participants in the 28 studies lost on average 4% from their baseline weight after one year of lifestyle intervention. In addition, weight loss increased by 0.26% with every added lifestyle session the participant attended.

Weight loss was relatively equal across the programs, regardless of whether they were facilitated by highly paid health professionals or lower cost lay staff taught to provide healthy eating and fitness advice.

The researchers concluded in the study’s abstract that “costs associated with diabetes prevention can be lowered without sacrificing effectiveness, using nonmedical personnel and motivating higher attendance at program sessions."

The study was published in the January issue of Health Affairs.