Impact of a Novel Diabetes Prevention Intervention for Early Slow Weight Loss Responders among Adults with Prediabetes: An Adaptive Trial

Objective: Some people are slower to respond during lifestyle interventions. An adaptive “rescue” intervention may improve outcomes among slow responders. The impact of a worksite “rescue” intervention for early slow responders was evaluated.

Research Design and Methods: Employees ≥ 21 years old with prediabetes were stratified to intervention using a 2.5% weight loss (%WL) threshold at week 5. Outcomes were assessed at baseline and 4-months using mixed effect and linear regression models.

Results: Significant improvement occurred in mean %WL, glycemia, total cholesterol, and triglycerides in the standard compared to adaptive (GLB+) intervention (all P ≤ 0.01). However, GLB+ also experienced significant reduction in %WL and glycemia (all P < 0.01). %WL at week 5 significantly predicted %WL at 4-months (P < 0.0001). Between-group difference of 4-month %WL was not significant for someone achieving 2.5%WL at week 5.

Conclusions: Diabetes prevention programs should consider weight loss success following one month of treatment and offer a “rescue” intervention to early slow weight loss responders.