American Diabetes Association
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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

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posted on 2023-08-31, 14:11 authored by Thirunavukkarasu Sathish, Kamlesh Khunti, K.M. Venkat Narayan, Viswanathan Mohan, Melanie J. Davies, Thomas Yates, Brian Oldenburg, Kavumpurathu R. Thankappan, Robyn J. Tapp, Ram Bajpai, Ranjit M. Anjana, Mary B. Weber, Mohammed K. Ali, Jonathan E. Shaw


To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by prediabetes phenotype.


We searched multiple databases until April 01, 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and IFG+IGT. Individual participant data were pooled from relevant trials and analyzed through random-effects models using the within-trial interactions approach.


Four trials with 2,794 participants (mean age 51.6 years, 60.6% 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 (95% CI) for diabetes incidence in i-IFG was 0.97 (0.66, 1.44), i-IGT was 0.65 (0.44, 0.96), and IFG+IGT was 0.51 (0.38, 0.68); Pinteraction=0.01.


Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.


Funding and Assistance. K.K., M.J.D., and T.Y. are supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM) and the NIHR Leicester Biomedical Research Centre (BRC). J.E.S. is supported by a National Health and Medical Research Council Investigator Grant. R.B. is affiliated with the National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC) West Midlands. MKA and KMVN are partially supported by the Georgia Center for Diabetes Translation Research, which is funded by the National Institutes of Health (P30DK111024). This research work did not receive any external funding.


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