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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

OBJECTIVE

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

RESEARCH DESIGN AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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