Randomised controlled trial evaluating the effectiveness of behavioural interventions to modify cardiovascular risk factors in men and women with impaired glucose tolerance: outcomes at 6 months

• Published in: Diabetes research and clinical practice 2001-04, Vol.52 (1), p.29-43
• Main Authors: Oldroyd, J.C, Unwin, N.C, White, M, Imrie, K, Mathers, J.C, Alberti, K.G.M.M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Behavior Therapy; Biological and medical sciences; Blood Glucose - metabolism; Body Weight; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Coronary heart disease; Diabetes. Impaired glucose tolerance; Diet; Diet Records; Dietary Fats; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Exercise; Female; Glucose Intolerance - complications; Glucose Intolerance - psychology; Glucose Intolerance - rehabilitation; Glucose Tolerance Test; Humans; Impaired glucose tolerance; Lipids - blood; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Middle Aged; Physical activity; Risk Factors; Type 2 diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/S0168-8227(00)00244-8

Aims: To evaluate the efficacy of interventions to promote a healthy diet and physical activity in people with impaired glucose tolerance (IGT). Methods: A randomised controlled trial in Newcastle upon Tyne, UK, 1995–98. Participants included 67 adults (38 men; 29 women) aged 24–75 years with IGT. The intervention consisted of regular diet and physical activity counselling based on the stages of change model. Main outcome measures were changes between baseline and 6 months in nutrient intake; physical activity; anthropometric and physiological measurements including serum lipids; glucose tolerance; insulin sensitivity. Results: The difference in change in total fat consumption was significant between intervention and control groups (difference −21.8 (95% confidence interval (CI) −37.8 to −5.8) g/day, P=0.008). A significantly larger proportion of intervention participants reported taking up vigorous activity than controls (difference 30.1, (95% CI 4.3–52.7)%, P=0.021). The change in body mass index was significantly different between groups (difference −0.95 (95% CI −1.5 to −0.4) kg/m 2, P=0.001). There was no significant difference in change in mean 2-h plasma glucose between groups (difference −0.19 (95% CI −1.1 to 0.71) mmol/l, NS) or in serum cholesterol (difference 0.02 (95% CI −0.26 to 0.31) mmol/l, NS). The difference in change in fasting serum insulin between groups was significant (difference −3.4 (95% CI −5.8 to −1.1) mU/l, P=0.005). Conclusions: After 6 months of intensive lifestyle intervention in participants with IGT, there were changes in diet and physical activity, some cardiovascular risk factors and insulin sensitivity, but not glucose tolerance. Further follow-up is in progress to investigate whether these changes are sustained or augmented over 2 years.