Session 8. Session 9. Apply the problem-solving model to eating and exercise problems. Session Teach participants to recognize personal triggers for slips, their reactions to those slips, and what it takes to get back on track. Teach participants to measure their heart rate and perceived level of exertion as a way of determining the appropriate levels of activity.
Discuss ways to cope with boredom by adding variety to the physical activity plan. Review specific strategies for coping with social events such as parties, vacations, and holidays. Introduce other strategies for staying motivated including posting signs of progress, setting new goals, creating friendly competition, and seeking social support from DPP staff and others.
Self-monitoring of weight Participants were weighed privately at the start of every individual session and were encouraged to weigh themselves at home daily or a minimum of once per week. Dietary modification The initial focus of the dietary intervention was on reducing total fat rather than calories.
Supervised activity sessions The protocol required that each clinical center offer supervised physical activity sessions at least two times per week throughout the trial. Extensive network of centralized training, feedback, and support In addition to local team support, a key feature of the DPP lifestyle intervention was an extensive centralized network of training, feedback, and support of the intervention staff.
Training All lifestyle coaches were required to attend annual, 2-day national training sessions conducted by the Lifestyle Resource Core. References 1. The Diabetes Prevention Program: design and methods for a clinical trial in the prevention of type 2 diabetes. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
N Engl J Med. Eriksson KF, Lindgarde F. Prevention of type 2 non-insulin-dependent diabetes mellitus by diet and physical exercise.
Can life-styles of subjects with impaired glucose tolerance be changed? A feasibility study Diabet Med. Does a lifestyle intervention program have an effect? Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. The Diabetes Prevention Program: baseline characteristics of the randomized cohort.
Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. Diabetes incidence in Pima Indians: contributions of obesity and parental diabetes. Can sustained weight loss in overweight individuals reduce the risk of diabetes mellitus? Wadden TA: The treatment of obesity: an overview.
New York, Raven Press, , p. Wing RR: Behavioral approaches to the treatment of obesity. New York, Marcel Dekker, , p. Primary prevention of hypertension by nutritional-hygienic means: final report of a randomized, controlled trial. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly TONE JAMA. Weight loss intervention in phase 1 of the trials of hypertension prevention.
Arch Intern Med. Are smaller weight losses or more achievable weight loss goals better in the long term for obese patients? J Consult Clin Psychol. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus.
Exercise in a behavioural weight control programme for obese patients with type 2 non-insulin-dependent diabetes. Centers for Disease Control and Prevention.
A randomized walking trial in postmenopausal women: effects of physical activity and health 10 years later. Effects of four maintenance programs on the long-term management of obesity. Support Center Support Center. External link. Please review our privacy policy. Build commitment to the DPP lifestyle change program by recording personal reasons for joining the DPP and perceived benefits to self, family, and others.
Introduce regular self-monitoring of weight at home. Practice self-monitoring skills, including weighing and measuring foods and estimating portion size of foods. Emphasize the importance of a regular meal pattern and eating slowly. Introduce physical activity and begin to build to minutes of physical activity over the next 4 weeks, using activities such as brisk walking.
Help participants learn to find the time to be physically active each day by including short bouts 10—15 min and healthy lifestyle activities, e.
Teach the fundamental principle of energy balance and what it takes to lose 1—2 lbs per week. Researchers met with participants individually at least 16 times in the first 24 weeks, and then every 2 months with at least 1 phone call between visits. Metformin Group — Group participants took mg of metformin twice a day and were provided standard advice about diet and physical activity.
Placebo Group — Group participants took a placebo twice a day instead of metformin and were provided standard advice about diet and physical activity.
DPPOS Results Year Findings At the year follow-up participants who took part in the DPP Lifestyle Change Program continued to have a delay in the development of diabetes by 34 percent—and developed diabetes about 4 years later—compared with participants who took a placebo. Participants from the DPP Lifestyle Change Program ages 60 and older had a delay in the development of diabetes by 49 percent. However, the participants from the DPP Lifestyle Change Program achieved these results with fewer blood pressure and cholesterol-lowering medications.
However, women from the DPP Lifestyle Change Program developed fewer small blood vessel problems than participants who continued to take metformin or took a placebo. Participants who did not develop diabetes had a 28 percent lower rate of small blood vessel problems compared with participants who developed diabetes.
There were some changes to the treatments each group received: Lifestyle Change Group —Group participants received quarterly group lifestyle change classes throughout the study and two group classes yearly to reinforce self-management behaviors for weight loss.
Metformin Group — Group participants received quarterly group lifestyle change classes throughout the study. Some risk factors--elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle--are potentially reversible.
We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes. Methods: We randomly assigned nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin mg twice daily , or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least minutes of physical activity per week.
References: Diabetes Care. Site Menu Home. Search Health Topics. Search the NIH Guide. NIH Research Matters.
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