RT Journal Article SR Electronic T1 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 JF BMJ Global Health JO BMJ Global Health FD BMJ Publishing Group Ltd SP e006479 DO 10.1136/bmjgh-2021-006479 VO 6 IS 11 A1 Muilwijk, Mirthe A1 Loh, Marie A1 Siddiqui, Samreen A1 Mahmood, Sara A1 Palaniswamy, Saranya A1 Shahzad, Khurram A1 Athauda, Lathika K A1 Jayawardena, Ranil A1 Batool, Tayyaba A1 Burney, Saira A1 Glover, Matthew A1 Bamunuarachchi, Vodathi A1 Panda, Manju A1 Madawanarachchi, Madawa A1 Rai, Baldeesh A1 Sattar, Iqra A1 Silva, Wnurinham A1 Waghdhare, Swati A1 Jarvelin, Marjo-Riitta A1 Rannan-Eliya, Ravindra Prasan A1 Wijemunige, Nilmini A1 Gage, Heather M A1 Valabhji, Jonathan A1 Frost, Gary S A1 Wickremasinghe, Rajitha A1 Kasturiratne, Anuradhani A1 Khawaja, Khadija I A1 Ahmad, Sajjad A1 van Valkengoed, Irene GM A1 Katulanda, Prasad A1 Jha, Sujeet A1 Kooner, Jaspal S A1 Chambers, John C YR 2021 UL http://gh.bmj.com/content/6/11/e006479.abstract AB 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.Data are available upon reasonable request. Data will be available to others after de-identification, on completion of the research, by application to the Steering Committee.