With over 60 million Americans diagnosed with prediabetes, putting them at increased risk for diabetes, cardiovascular events and other obesity-related ailments, finding ways to help large populations avoid these complications is an important initiative. In an article published in the October 2008 issue of the American Journal of Preventive Medicine, researchers from the Indiana University School of Medicine report that organizations such as the YMCA can be an effective vehicle for diabetes-prevention education.
A number of significant studies, such as the Diabetes Prevention Program (DPP), have shown that structured diet and physical exercise can significantly reduce the progression of prediabetes to diabetes. These trials involved strict enrollment criteria and major lifestyle changes that are difficult to translate into large-scale, community-level programs.
With over 2,500 facilities serving more than 10,000 rural, suburban and inner-city communities, and a long history of implementing successful health promotion programs, the YMCA is in a unique position to help develop this pilot study for large-scale outreach. Two facilities, located in semi-urban neighborhoods in greater Indianapolis, Indiana, participated in the current study. One offered the increased DPP-style intervention while the other offered standard diabetes-prevention advice (controls).
The study involved 92 participants, divided into an intervention group (46) and a control group. Both groups received baseline educational materials, but the intervention group was offered a core curriculum involving 16 classroom-style meetings focused on building knowledge and skills for goal setting, self-monitoring and problem-solving. Program sessions lasted 60-90 minutes, and the entire core curriculum was delivered over 16-20 weeks.
At the 4-6-month follow-up visit, body weight decreased by 6.0% in intervention participants and 2.0% in control participants. This was equal to a mean weight loss of 5.7 kg (12.5 lbs) for intervention participants and 1.8 kg (4.0 lbs) for controls, a clinically meaningful and significant difference. There was also a significant and clinically meaningful difference in the change in total cholesterol concentration (-21.6 mg/dL intervention vs +6 mg/dL controls). All of these differences persisted at the 12-14 month follow-up visits.
Writing in the article, Ronald T. Ackermann, MD, MPH, states, "This is the first study to demonstrate that the YMCA is a promising vehicle for the dissemination of the DPP lifestyle intervention into the community…In this pilot study, people at high risk for developing diabetes achieved and maintained a mean 6% reduction in baseline body weight and significant reductions in total cholesterol. Given these results, delivery of the DPP via the YMCA warrants further study as a model for the wide-scale dissemination of an evidence-based strategy to lower diabetes and cardiometabolic risk for millions of Americans with prediabetes."
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