Effect of Conventional Lifestyle Interventions on Type 2 Diabetes Incidence by Glucose-Defined Prediabetes Phenotype: An Individual Participant Data Meta-analysis of Randomized Controlled Trials.

Publisher: American Diabetes Association Country of Publication: United States NLM ID: 7805975 Publication Model: Print Cited Medium: Internet ISSN: 1935-5548 (Electronic) Linking ISSN: 01495992 NLM ISO Abbreviation: Diabetes Care Subsets: MEDLINE

Publication: Alexandria Va : American Diabetes Association
Original Publication: New York, American Diabetes Assn.

Diabetes Mellitus, Type 2*/epidemiology ; Diabetes Mellitus, Type 2*/prevention & control ; Diabetes Mellitus, Type 2*/etiology ; Glucose Intolerance*/epidemiology ; Glucose Intolerance*/therapy ; Glucose Intolerance*/complications ; Prediabetic State*/epidemiology ; Prediabetic State*/therapy ; Prediabetic State*/complications; Female ; Humans ; Male ; Middle Aged ; Blood Glucose ; Fasting ; Glucose ; Incidence ; Randomized Controlled Trials as Topic

Objective: To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by glucose-defined prediabetes phenotype.
Research Design and Methods: We searched multiple databases until 1 April 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and impaired fasting glucose plus impaired glucose tolerance (IFG+IGT). Individual participant data were pooled from relevant trials and analyzed through random-effects models with use of the within-trial interactions approach.
Results: Four trials with 2,794 participants (mean age 53.0 years, 60.7% men) were included: 1,240 (44.4%), 796 (28.5%), and 758 (27.1%) had i-IFG, i-IGT, and IFG+IGT, respectively. After a median of 2.5 years, the pooled hazard ratio for diabetes incidence in i-IFG was 0.97 (95% CI 0.66, 1.44), i-IGT 0.65 (0.44, 0.96), and IFG+IGT 0.51 (0.38, 0.68; Pinteraction = 0.01).
Conclusions: Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.
(© 2023 by the American Diabetes Association.)

Comment in: Diabetes Care. 2023 Nov 1;46(11):1894-1896. (PMID: 37890107)

Nat Rev Endocrinol. 2020 Jul;16(7):395-400. (PMID: 32060416)
Diabetes Care. 2006 May;29(5):1130-9. (PMID: 16644654)
Int J Methods Psychiatr Res. 2011 Mar;20(1):40-9. (PMID: 21499542)
Diabetes Care. 2023 Jan 1;46(Suppl 1):S19-S40. (PMID: 36507649)
BMJ. 2019 Aug 28;366:l4898. (PMID: 31462531)
JAMA. 2015 Apr 28;313(16):1657-65. (PMID: 25919529)
Stat Med. 2020 Jul 10;39(15):2115-2137. (PMID: 32350891)
Lancet Diabetes Endocrinol. 2017 Aug;5(8):585-596. (PMID: 28601585)
Arch Intern Med. 2011 Aug 8;171(15):1352-60. (PMID: 21824948)
Implement Sci. 2018 Jul 18;13(1):97. (PMID: 30021592)
BMJ. 2008 Apr 26;336(7650):924-6. (PMID: 18436948)
Nutrients. 2017 Nov 22;9(11):. (PMID: 29165385)
Cochrane Database Syst Rev. 2018 Oct 29;10:CD012661. (PMID: 30371961)
PLoS Med. 2018 Jun 6;15(6):e1002575. (PMID: 29874236)
JAMA Intern Med. 2017 Dec 1;177(12):1808-1817. (PMID: 29114778)
Prev Med. 2016 Mar;84:48-56. (PMID: 26740346)
Diabetes Care. 2016 Oct;39(10):1760-7. (PMID: 27504014)

P30 DK111024 United States DK NIDDK NIH HHS; UL1 TR002378 United States TR NCATS NIH HHS; 75D30120P0742 United States CC CDC HHS; UL1TR002378 United States TR NCATS NIH HHS

0 (Blood Glucose)
IY9XDZ35W2 (Glucose)

Date Created: 20230831 Date Completed: 20231031 Latest Revision: 20240207

20240207

PMC10620543

10.2337/dc23-0696

37650824