University of Oulu

Muilwijk M, Loh M, Siddiqui S, et al. Effects of a lifestyle intervention programme after 1 year of follow-up among South Asians at high risk of type 2 diabetes: a cluster randomised controlled trial. BMJ Global Health 2021;6:e006479

Effects of a lifestyle intervention programme after 1 year of follow-up among South Asians at high risk of type 2 diabetes : a cluster randomised controlled trial

Saved in:
Author: Muilwijk, Mirthe1; Loh, Marie2,3; Siddiqui, Samreen4;
Organizations: 1Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
2Lee Kon Chian School of Medicine, Nanyang Technological University, Singapore
3Department of Epidemiology and Biostatistics, Imperial College London, London, UK
4Institute of Endocrinology Diabetes and Metabolism, Max Healthcare, New Delhi, Delhi, India
5Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
6Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
7Punjab Institute of Cardiology, Lahore, Punjab, Pakistan
8Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
9Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Western, Sri Lanka
10Department of Endocrinology and Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
11School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
12Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Western, Sri Lanka
13School of Public Health, Imperial College London, London, UK
14Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK
15Unit of Primary Care, Oulu University Hospital, Oulu, Finland
16Institute for Health Policy, Colombo, Sri Lanka
17Surrey Health Economics Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, Surrey, UK
18Department of Diabetes and Endocrinology, Imperial College London, London, UK
19Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
20Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
21London North West University Healthcare NHS Trust, Harrow, London, UK
22National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022020417593
Language: English
Published: BMJ, 2021
Publish Date: 2022-02-04
Description:

Abstract

Introduction: South Asians are at high risk of type 2 diabetes (T2D). We assessed whether intensive family-based lifestyle intervention leads to significant weight loss, improved glycaemia and blood pressure in adults at elevated risk for T2D.

Methods: This cluster randomised controlled trial (iHealth-T2D) was conducted at 120 locations across India, Pakistan, Sri Lanka and the UK. We included 3684 South Asian men and women, aged 40–70 years, without T2D but with raised haemoglobin A1c (HbA1c) and/or waist circumference. Participants were randomly allocated either to the family-based lifestyle intervention or control group by location clusters. Participants in the intervention received 9 visits and 13 telephone contacts by community health workers over 1-year period, and the control group received usual care. Reductions in weight (aim >7% reduction), waist circumference (aim ≥5 cm reduction), blood pressure and HbA1C at 12 months of follow-up were assessed. Our linear mixed-effects regression analysis was based on intention-to-treat principle and adjusted for age, sex and baseline values.

Results: There were 1846 participants in the control and 1838 in the intervention group. Between baseline and 12 months, mean weight of participants in the intervention group reduced by 1.8 kg compared with 0.4 kg in the control group (adjusted mean difference −1.10 kg (95% CI −1.70 to −1.06), p<0.001). The adjusted mean difference for waist circumference was −1.9 cm (95% CI −2.5; to 1.3), p<0.001). No overall difference was observed for blood pressure or HbA1c. People who attended multiple intervention sessions had a dose-dependent effect on waist circumference, blood pressure and HbA1c, but not on weight.

Conclusion: An intensive family-based lifestyle intervention adopting low-resource strategies led to effective reduction in weight and waist circumference at 12 months, which has potential long-term benefits for preventing T2D. A higher number of attended sessions increased the effect on waist circumference, blood pressure and HbA1c.

Trial registration number: EudraCT: 2016-001350-18; ClinicalTrials.gov: NCT02949739.

see all

Series: BMJ global health
ISSN: 2059-7908
ISSN-E: 2059-7908
ISSN-L: 2059-7908
Volume: 6
Issue: 11
Article number: e006479
DOI: 10.1136/bmjgh-2021-006479
OADOI: https://oadoi.org/10.1136/bmjgh-2021-006479
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Subjects:
Funding: The iHealth-T2D trial was funded by the European Commission (grant award 643774).
Copyright information: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
  https://creativecommons.org/licenses/by-nc/4.0/