A systematic review of the translational research on the Diabetes Prevention Program.

International clinical trials have demonstrated compelling evidence on the prevention or delay of type 2 diabetes (T2D) by lifestyle change programs. Numerous studies have translated the Diabetes Prevention Program (DPP) protocol to "real-world" settings. The purpose of this paper is to review the translational research of the DPP protocol in adults at-risk for T2D. This study is a systematic review based on the guidelines from the Cochrane Handbook for Systematic Reviews. There were 16 studies that translated the DPP protocol in four distinct settings: (a) hospital outpatient, (b) primary care, (c) community, and (d) work and church. Settings varied considerably in terms of reach, efficacy, adoption, implementation, and maintenance. There were strengths and limitations to each setting. Better understanding of program adaptation and mediators and moderators to program efficacy are indicated. Future research also needs to continue to explore mechanisms to improve access and long-term outcomes.