Effect of a family and interdisciplinary intervention to prevent T2D: randomized clinical trial View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-01-22

AUTHORS

Katya Vargas-Ortiz, Georgina Lira-Mendiola, Claudia M. Gómez-Navarro, Katya Padilla-Estrada, Fabiola Angulo-Romero, José M. Hernández-Márquez, Ana K. Villa-Martínez, Jessica N. González-Mena, Maciste H. Macías-Cervantes, Maria de Lourdes Reyes-Escogido, Rodolfo Guardado-Mendoza

ABSTRACT

BackgroundLifestyle changes can reduce the risk of T2D; however, no study has evaluated the effect of a lifestyle intervention involving patients´ family. The aim of this study was to compare the impact of an interdisciplinary family (FI) Vs individual intervention (II) on glucose metabolism, insulin resistance (IR), pancreatic β-cell function and cardiovascular risk markers in patients with prediabetes, as well as to measure the impact on their families’ metabolic risk.MethodsRandomized Clinical Trial (RCT) to compare the impact of FI and II on IR and pancreatic β-cell function in subjects with prediabetes. There were 122 subjects with prediabetes (and 101 family members) randomized to FI or II. Data were collected in 2015–2016 and analyzed in 2017–2018. FI group had the support of their family members, who also received personalized diet and exercise recommendations; patients and their family members attended monthly a lifestyle enhancement program. II group received personalized diet and exercise recommendations. The follow-up was for 12 months. Glucose, IR, pancreatic β-cell function and secondary outcomes (body composition and lipid profile) were assessed at baseline, 6 and 12 months.ResultsFI group improved area under the glucose curve (AUC) (from 18,597 ± 2611 to 17,237 ± 2792, p = 0.004) and the Matsuda index (from 3.5 ± 2.3 to 4.7 ± 3.5, p = 0.05) at 12 months. II group improved Disposition Index (from 1.5 ± 0.4 to 1.9 ± 0.73, p < .0001) at 12 months.The improvements achieved in weight and lipids at 6 months, were lost in II group at 12 moths, whereas in FI persisted. Adherence up to 12 months was not different between the study groups (FI 56% Vs II 60%).ConclusionsFI intervention was more effective by improving glucose AUC, insulin sensitivity and lipid profile, besides that, metabolic risk in family members of the FI group was maintained, while the risk of II group was increased.Trial registrationThis study was retrospectively registered at clinicaltrials.gov on December 15, 2015 (NTC026365646). More... »

PAGES

97

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12889-020-8203-1

DOI

http://dx.doi.org/10.1186/s12889-020-8203-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1124229647

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31969136


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28 schema:description BackgroundLifestyle changes can reduce the risk of T2D; however, no study has evaluated the effect of a lifestyle intervention involving patients´ family. The aim of this study was to compare the impact of an interdisciplinary family (FI) Vs individual intervention (II) on glucose metabolism, insulin resistance (IR), pancreatic β-cell function and cardiovascular risk markers in patients with prediabetes, as well as to measure the impact on their families’ metabolic risk.MethodsRandomized Clinical Trial (RCT) to compare the impact of FI and II on IR and pancreatic β-cell function in subjects with prediabetes. There were 122 subjects with prediabetes (and 101 family members) randomized to FI or II. Data were collected in 2015–2016 and analyzed in 2017–2018. FI group had the support of their family members, who also received personalized diet and exercise recommendations; patients and their family members attended monthly a lifestyle enhancement program. II group received personalized diet and exercise recommendations. The follow-up was for 12 months. Glucose, IR, pancreatic β-cell function and secondary outcomes (body composition and lipid profile) were assessed at baseline, 6 and 12 months.ResultsFI group improved area under the glucose curve (AUC) (from 18,597 ± 2611 to 17,237 ± 2792, p = 0.004) and the Matsuda index (from 3.5 ± 2.3 to 4.7 ± 3.5, p = 0.05) at 12 months. II group improved Disposition Index (from 1.5 ± 0.4 to 1.9 ± 0.73, p < .0001) at 12 months.The improvements achieved in weight and lipids at 6 months, were lost in II group at 12 moths, whereas in FI persisted. Adherence up to 12 months was not different between the study groups (FI 56% Vs II 60%).ConclusionsFI intervention was more effective by improving glucose AUC, insulin sensitivity and lipid profile, besides that, metabolic risk in family members of the FI group was maintained, while the risk of II group was increased.Trial registrationThis study was retrospectively registered at clinicaltrials.gov on December 15, 2015 (NTC026365646).
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35 Enhancement Program
36 FI group
37 Matsuda index
38 MethodsRandomized clinical trials
39 Secondary outcomes
40 T2D
41 adherence
42 aim
43 area
44 baseline
45 cardiovascular risk markers
46 changes
47 clinical trials
48 curves
49 data
50 diet
51 disposition index
52 effect
53 exercise recommendations
54 family
55 family members
56 function
57 glucose
58 glucose AUC
59 glucose curve
60 glucose metabolism
61 group
62 impact
63 impact of family
64 improvement
65 index
66 individual interventions
67 insulin resistance
68 insulin sensitivity
69 interdisciplinary intervention
70 intervention
71 lifestyle enhancement program
72 lifestyle intervention
73 lipid profile
74 lipids
75 markers
76 members
77 metabolic risk
78 metabolism
79 months
80 moth
81 outcomes
82 pancreatic β-cell function
83 patient's family
84 patients
85 personalized diet
86 prediabetes
87 profile
88 program
89 recommendations
90 resistance
91 risk
92 risk markers
93 risk of T2D
94 sensitivity
95 study
96 study group
97 subjects
98 support
99 trials
100 weight
101 β-cell function
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