Kazue Yamaoka1, Toshiro Tango. 1. Department of Technology Assessment and Biostatistics, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama 351-0197, Japan. yamaoka@niph.go.jp
Abstract
OBJECTIVE: To evaluate the efficacy of lifestyle education for preventing type 2 diabetes in individuals at high risk by meta-analysis of randomized controlled trials, as assessed by incidence and a reduced level of plasma glucose 2 h after a 75-g oral glucose load (2-h plasma glucose). RESEARCH DESIGN AND METHODS: Through an electronic search, 123 studies were identified. A literature search identified eight studies that met strict inclusion criterion of meta-analysis for 2-h plasma glucose and five studies for the incidence of diabetes. All were randomized controlled trials of > or =6 months with lifestyle education that included a dietary intervention. Subjects were adults diagnosed as being at high risk for type 2 diabetes. The difference in mean reduction of 2-h plasma glucose from baseline to the 1-year follow-up and relative risk (RR) of the incidence of diabetes in the lifestyle education group versus the control group were assessed. Overall estimates were calculated using a random-effects model. Those estimates were confirmed by several models, and the possibility of selection bias was examined using a funnel plot. RESULTS: Lifestyle education intervention reduced 2-h plasma glucose by 0.84 mmol/l (95% CI 0.39-1.29) compared with the control group. The 1-year incidence of diabetes was reduced by approximately 50% (RR 0.55, 95% CI 0.44-0.69) compared with the control group. Results were stable and little changed if data were analyzed by subgroups or other statistical models. Funnel plots revealed no selection bias. CONCLUSIONS: Lifestyle education was effective for reducing both 2-h plasma glucose and RR in high-risk individuals and may be a useful tool in preventing diabetes.
OBJECTIVE: To evaluate the efficacy of lifestyle education for preventing type 2 diabetes in individuals at high risk by meta-analysis of randomized controlled trials, as assessed by incidence and a reduced level of plasma glucose 2 h after a 75-g oral glucose load (2-h plasma glucose). RESEARCH DESIGN AND METHODS: Through an electronic search, 123 studies were identified. A literature search identified eight studies that met strict inclusion criterion of meta-analysis for 2-h plasma glucose and five studies for the incidence of diabetes. All were randomized controlled trials of > or =6 months with lifestyle education that included a dietary intervention. Subjects were adults diagnosed as being at high risk for type 2 diabetes. The difference in mean reduction of 2-h plasma glucose from baseline to the 1-year follow-up and relative risk (RR) of the incidence of diabetes in the lifestyle education group versus the control group were assessed. Overall estimates were calculated using a random-effects model. Those estimates were confirmed by several models, and the possibility of selection bias was examined using a funnel plot. RESULTS: Lifestyle education intervention reduced 2-h plasma glucose by 0.84 mmol/l (95% CI 0.39-1.29) compared with the control group. The 1-year incidence of diabetes was reduced by approximately 50% (RR 0.55, 95% CI 0.44-0.69) compared with the control group. Results were stable and little changed if data were analyzed by subgroups or other statistical models. Funnel plots revealed no selection bias. CONCLUSIONS: Lifestyle education was effective for reducing both 2-h plasma glucose and RR in high-risk individuals and may be a useful tool in preventing diabetes.
Authors: Tarissa Beatrice Zanata Petry; Pedro Paulo Caravatto; Fernando Quirino Pechy; Jose Luis Lopes Correia; Catia Cristina Lorenzi Guerbali; Regina Marcelina da Silva; João Eduardo Salles; Ricardo Cohen Journal: Curr Atheroscler Rep Date: 2015-09 Impact factor: 5.113
Authors: Cintia González; Pau Herrero; José M Cubero; José M Iniesta; M Elena Hernando; Gema García-Sáez; Alvaro J Serrano; Iñaki Martinez-Sarriegui; Carmen Perez-Gandia; Enrique J Gómez; Esther Rubinat; Valeria Alcantara; Eulalia Brugués; Ana Chico; Eugenia Mato; Olga Bell; Rosa Corcoy; Alberto de Leiva Journal: J Diabetes Sci Technol Date: 2013-07-01