A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes

Aim. - To compare the effectiveness and cost of two lifestyle-modification programmes in individuals at high risk of developing type 2 diabetes. Methods. - Forty-eight men and women with a body mass index >= 27 kg/m(2) and prediabetes were randomly assigned to either a 1-year interdisciplinary intervention including individual counseling every 6 weeks and 25 group seminars (group I; n = 22) or a group intervention comprising seminars only (group G; n = 26). These interventions were compared in terms of weight loss and improvement of anthropometric measures, metabolic variables and costs. Results. - Participants in group I lost an average of 4.9 kg (95% CI: -7.3, -2.4; P < 0.01) and 5 cm in waist circumference (95% CI: -7.0, -3.0; P < 0.01), whereas no significant change was noted in those assigned to group G. Among the participants in group I, 50 and 27% lost at least 5 and 10% of their initial weight, respectively, compared with only 12 and 4%, respectively, in group G. Fasting glucose, 2-hour glucose and lipid profiles improved significantly in group I, and no participant (zero on 22) developed diabetes compared with 11.5% (3/26) in group G. Most participants (nine on 11) with impaired fasting glucose in group I returned to normal. The direct cost of the individual intervention was estimated to be $733.06/year per subject compared with $81.36/year per subject for the group intervention. Conclusion. - This study demonstrates that a low-cost, moderate-intensity, individual interdisciplinary approach combined with group seminars leads to clinically significant weight loss and metabolic improvement in people with prediabetes. Group seminars alone were not effective in this population (www.ClinicalTrial.gov, Identifier: NCT00991549). (C) 2011 Elsevier Masson SAS. All rights reserved.