Science & Technology: Community-based Programs Can Cut Risk of Diabetes, Pitt Researchers Find

Adults in urban, medically underserved communities can decrease their risk for Type II diabetes and cardiovascular disease by participating in community-based group programs focused on moderate weight loss and increased physical activity, according to a study by University of Pittsburgh Diabetes Institute (UPDI) researchers published in this month’s issue of Diabetes Care.

The study was based on the successful national Diabetes Prevention Program (DPP), which found that moderate weight loss and increased physical activity were more successful than medication in preventing diabetes and heart disease in people at risk for these diseases. Researchers translated the DPP program from an intensive, individually delivered intervention into a group program offered in the community using a combination of professional and paraprofessional staff.

“To our knowledge, this is one of the few studies to demonstrate the feasibility and effectiveness of translating the national DPP into a program for an urban, medically underserved community. Moreover, it is one of very few that demonstrate sustained weight loss and risk factor reduction in a community setting,” said Miriam Seidel, diabetes project manager at UPDI.

The researchers studied 88 participants with metabolic syndrome in urban, medically underserved areas. The target urban community near Pittsburgh was a former hub of the steel industry that experienced industrial downsizing in the 1980s. This led to increased rates of unemployment and outmigration of the young and more affluent, resulting in a predominately older, socioeconomically depressed area with a high prevalence of chronic diseases like diabetes. The majority of study participants were female with an average age of 54 years. About 75 percent had at least a high school education and a family history of diabetes, and nearly 60 percent of the study households had an annual income below 200 percent of the national poverty level.

The participants took part in 12 weekly sessions of the community-based Group Lifestyle Balance intervention program, focusing on safe weight loss, healthy food choices, and physical activity. Nearly half of the subjects lost at least 5 percent of their body weight, and approximately one-quarter lost at least 7 percent. Significant improvements also occurred in waist circumference and blood pressure levels following the intervention, and most of the changes were sustained after six months.

“These preliminary results suggest that adults in urban, medically underserved areas can decrease their risk for Type II diabetes and cardiovascular disease through participation in community-based group programs,” noted Seidel. “As the incidence of obesity and diabetes continues to rise in this country, it is important to have practical and cost-effective programs to address this national crisis. We hope that health insurers will begin to cover the cost of this type of intervention and track the clinical outcomes of their members who participate in diabetes prevention programs.” The researchers will continue to follow the original study participants for up to two years and will report the results at a later date.

Coauthors of the study include Robert O. Powell, UPMC Braddock; Janice C. Zgibor, director of evaluation at UPDI and a professor in the Department of Epidemiology within Pitt’s Graduate School of Public Health (GSPIA); Linda M. Siminerio, a professor of medicine in the Pitt School of Medicine’s Department of Endocrinology and UPDI executive director; and Gretchen A. Piatt, a doctoral candidate in GSPIA’s Department of Epidemiology.