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.