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Presentation dpp-1

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Neelam Singh
Neelam Singh

The document summarizes research from the Diabetes Prevention Program (DPP) clinical trial. The trial involved 3,234 participants with prediabetes who were assigned to either a lifestyle intervention group, medication (metformin) group, or placebo group. The lifestyle group aimed to lose 7% of body weight through diet and exercise. The results showed that the risk of developing diabetes decreased by 58% in the lifestyle group and 31% in the metformin group compared to placebo. Follow up studies found the risk reduction from the lifestyle intervention lasted for over 15 years at rates of 27-34%, demonstrating prevention can be long lasting. The document also provides details on eligibility, program structure, discussion topics, recommended foods, and potential barriers for D

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Presentation dpp-1
THE PROBLEM HIGHER RISK FOR TYPE 2 DIABETES, HEART DISEASE, AND STROKESource: CDC (2017)
DPP ORIGINAL RESEARCH MULTICENTER NIH CLINICAL TRIAL 3,234 PARTICIPANTS WITH PREDIABETES 27 CLINICAL CENTERS IN U.S. LIFESTYLE REDUCED CALORIES, LOW-FAT DIET 150 MINUTES OF EXERCISE PER WEEK (30 MINUTES OF WALKING 5 DAYS PER WEEK) WEIGHT LOSS GOAL = 7% OF BODY WEIGHT MEDICATION 850 MILLIGRAMS METFORMIN TWICE DAILY PLACEBO STUDY RESULTS LIFESTYLE RISK FOR DEVELOPING DIABETES DECREASED BY 58% METFORMIN RISK FOR DEVELOPING DIABETES DECREASED BY 31% DPP Research Group. New England Journal of Medicine. 346: 393-403, 2002.
PREVENTION CAN LAST 15+ YEARS Intervention Risk Reduction @ 3 Years Risk Reduction @ 10 Years Risk Reduction @ 15 years Lifestyle 58% 34% 27% Metformin 31% 18% 18% DPP Research Group. Lancet. 374: 1677-1686, 2009. Lancet Diabetes Endocrinology. DOI: http://dx.doi.org/10.1016/S2213-8587(15)00291-0, 2015.
THE 1 YEAR PROGRAM HELPS MAKE HEALTHY LIFESTYLE CHANGES THAT LAST, HOLD PARTICIPANT ACCOUNTABLE BY ATTENDING CLASSES, AND GET SUPPORT FORM THE GROUP TO HELP MEET GOALS! PROGRAM GOALS WEIGHT LOSS: 5-7% OF STARTING BODY WEIGHT INCREASING PHYSICAL ACTIVITY TO 150 MINUTES + PROGRAM STRUCTURE 1 Year Program: weekly, bi-monthly & monthly sessions one hour sessions with make-ups available self-monitoring of weight, food intake, minutes of physical activity required goal/action plan set at each session The Power of Peer Support: trained lifestyle coach leverages group process to allow group to problem- solve and support change
ELIGIBLE NATIONAL DPP PARTICIPANTS OVERWEIGHT & OBESE ADULTS: ADULT AGED 18 YEARS AND OLDER WITH A BMI OF 25 OR GREATER (ASIAN AMERICANS: 23 OR GREATER) WITH PREDIABETES AND/OR AT RISK FOR DIABETES: PREDIABETES DIAGNOSED THROUGH BLOOD TEST FASTING BLOOD SUGAR, A1C, ORAL GLUCOSE TOLERANCE TEST OR HISTORY OF GESTATIONAL DIABETES MEDICARE BENEFICIARIES ALSO NEED BLOOD TEST ABOVE OR INCREASED RISK BASED ON PREDIABETES RISK QUIZ FOR THOSE WITHOUT MEDICARE HTTPS://DOIHAVEPREDIABETES.ORG/PDF/PREDIABETES_RISKTEST_12.11.PDF
DISCUSSION TOPICS (26 CDC SESSIONS) EATING WELL INCLUDING SHOPPING, COOKING, EATING AWAY FROM HOME, ETC. GETTING ACTIVE COPING WITH TRIGGERS POSITIVE THINKING MANAGING STRESS GETTING SUPPORT HEART HEALTH CARBOHYDRATES BURNMORE CALORIES THANYOU TAKE IN STAYING MOTIVATED
HEALTHY MEAL BASED ON MY PLATE IDEA FROM THE AMERICAN DIABETES ASSOCIATION. (MEETS THE DRI NEEDS)
HEALTHY DPP DIET FOR PREDIABETES FOODS TO EMPHASIZE Vegetables Fish Plant-based proteins, such as beans, peas, lentils, tofu, and nuts Whole grains and whole-grain products Healthy fats such as olive oil and avocado Fresh fruit Spices and herbs Starchy vegetables (e.g., Peas, winter squash, corn, and sweet potatoes) Lean animal proteins, such as skinless poultry and eggs. Reduced-fat dairy products, such as low-fat cheese and fat-free cottage cheese and plain yogurt. Water and other low-calorie, hydrating beveragES SUCH AS DECAFFEINATED GREEN TEA. PROS Lower insulin resistance and blood glucose levels (a1c). Lower blood pressure, improving cholesterol levels. Can aid in weight loss due to: Weekly weigh in, daily tracking of food, physical acty.. Calorie reduction by swapping low-calorie foods such as lean proteins and vegetables, and having smaller portions Swapping empty calories for high-fiber choices such as fruit and whole grains. Suggestions for small changes. Allowances for special occasions and cravings. https://www.ncbi.nlm.nih.gov/pubmed/22812594
HEALTHY DPP DIET FOR PREDIABETES FOODS TO LIMIT OR AVOID PROCESSED MEATS FRIED FOODS FATTY RED MEAT AND POULTRY WITH SKIN SOLID FATS (E.G., LARD AND BUTTER) REFINED GRAINS (E.G., WHITE BREAD, PASTA, RICE, AND CRACKERS, AND REFINED CEREALS) SWEETS (E.G., CANDY, CAKE, ICE CREAM, PIE, PASTRIES, AND COOKIES) SUGAR-SWEETENED BEVERAGES, (E.G., SOFT DRINKS, ENERGY DRINKS, SPORTS DRINKS, AND SUGAR-SWEETENED COFFEE AND TEA BEVERAGES) ALCOHOLIC BEVERAGES AND MIXED DRINKS SUGAR-SWEETENED FOODS, SUCH AS FLAVORED YOGURT AND OATMEAL, AND SUGARY CONDIMENTS DRIED FRUIT AND FRUIT JUICE Water and other low-calorie, hydrating beveragES SUCH AS DECAFFEINATED GREEN TEA. CONS IS LESS FOCUSED ON COUNTING CALORIES AND GRAMS OF CARBOHYDRATE, FAT, AND PROTEIN GRAMS . IS NOT A PRESCRIPTIVE MEAL PLAN
EXPERIENCE ON DIET Easy to follow Choose from variety of food Cant stick to well crafted plan. Effort to enter data and track Hard to meet Iron Easy to met Vit A, C, Calcium, Potassium High on fiber, low on sodium Weight lost : 遜 pound (62.5- 62.1)
Time constraints Low appetite Modifying for whole family Low motivation Data entry Eating out Too many vegetables
WAYS TO ADDRESS BARRIERS/CHALLENGES FIND OUT THE MOTIVATION SMALL STEPS AT A TIME FRESH. FROZEN, CANNED ALL COUNTS TOWARDS MEETING DAILY GOAL MENU PLANNING, GROCERY LIST, STOCKING PANTRY. LOGGING ON THE DAYS YOU THINK YOU EAT MORE.
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Presentation dpp-1

  • 2. THE PROBLEM HIGHER RISK FOR TYPE 2 DIABETES, HEART DISEASE, AND STROKESource: CDC (2017)
  • 3. DPP ORIGINAL RESEARCH MULTICENTER NIH CLINICAL TRIAL 3,234 PARTICIPANTS WITH PREDIABETES 27 CLINICAL CENTERS IN U.S. LIFESTYLE REDUCED CALORIES, LOW-FAT DIET 150 MINUTES OF EXERCISE PER WEEK (30 MINUTES OF WALKING 5 DAYS PER WEEK) WEIGHT LOSS GOAL = 7% OF BODY WEIGHT MEDICATION 850 MILLIGRAMS METFORMIN TWICE DAILY PLACEBO STUDY RESULTS LIFESTYLE RISK FOR DEVELOPING DIABETES DECREASED BY 58% METFORMIN RISK FOR DEVELOPING DIABETES DECREASED BY 31% DPP Research Group. New England Journal of Medicine. 346: 393-403, 2002.
  • 4. PREVENTION CAN LAST 15+ YEARS Intervention Risk Reduction @ 3 Years Risk Reduction @ 10 Years Risk Reduction @ 15 years Lifestyle 58% 34% 27% Metformin 31% 18% 18% DPP Research Group. Lancet. 374: 1677-1686, 2009. Lancet Diabetes Endocrinology. DOI: http://dx.doi.org/10.1016/S2213-8587(15)00291-0, 2015.
  • 5. THE 1 YEAR PROGRAM HELPS MAKE HEALTHY LIFESTYLE CHANGES THAT LAST, HOLD PARTICIPANT ACCOUNTABLE BY ATTENDING CLASSES, AND GET SUPPORT FORM THE GROUP TO HELP MEET GOALS! PROGRAM GOALS WEIGHT LOSS: 5-7% OF STARTING BODY WEIGHT INCREASING PHYSICAL ACTIVITY TO 150 MINUTES + PROGRAM STRUCTURE 1 Year Program: weekly, bi-monthly & monthly sessions one hour sessions with make-ups available self-monitoring of weight, food intake, minutes of physical activity required goal/action plan set at each session The Power of Peer Support: trained lifestyle coach leverages group process to allow group to problem- solve and support change
  • 6. ELIGIBLE NATIONAL DPP PARTICIPANTS OVERWEIGHT & OBESE ADULTS: ADULT AGED 18 YEARS AND OLDER WITH A BMI OF 25 OR GREATER (ASIAN AMERICANS: 23 OR GREATER) WITH PREDIABETES AND/OR AT RISK FOR DIABETES: PREDIABETES DIAGNOSED THROUGH BLOOD TEST FASTING BLOOD SUGAR, A1C, ORAL GLUCOSE TOLERANCE TEST OR HISTORY OF GESTATIONAL DIABETES MEDICARE BENEFICIARIES ALSO NEED BLOOD TEST ABOVE OR INCREASED RISK BASED ON PREDIABETES RISK QUIZ FOR THOSE WITHOUT MEDICARE HTTPS://DOIHAVEPREDIABETES.ORG/PDF/PREDIABETES_RISKTEST_12.11.PDF
  • 7. DISCUSSION TOPICS (26 CDC SESSIONS) EATING WELL INCLUDING SHOPPING, COOKING, EATING AWAY FROM HOME, ETC. GETTING ACTIVE COPING WITH TRIGGERS POSITIVE THINKING MANAGING STRESS GETTING SUPPORT HEART HEALTH CARBOHYDRATES BURNMORE CALORIES THANYOU TAKE IN STAYING MOTIVATED
  • 8. HEALTHY MEAL BASED ON MY PLATE IDEA FROM THE AMERICAN DIABETES ASSOCIATION. (MEETS THE DRI NEEDS)
  • 9. HEALTHY DPP DIET FOR PREDIABETES FOODS TO EMPHASIZE Vegetables Fish Plant-based proteins, such as beans, peas, lentils, tofu, and nuts Whole grains and whole-grain products Healthy fats such as olive oil and avocado Fresh fruit Spices and herbs Starchy vegetables (e.g., Peas, winter squash, corn, and sweet potatoes) Lean animal proteins, such as skinless poultry and eggs. Reduced-fat dairy products, such as low-fat cheese and fat-free cottage cheese and plain yogurt. Water and other low-calorie, hydrating beveragES SUCH AS DECAFFEINATED GREEN TEA. PROS Lower insulin resistance and blood glucose levels (a1c). Lower blood pressure, improving cholesterol levels. Can aid in weight loss due to: Weekly weigh in, daily tracking of food, physical acty.. Calorie reduction by swapping low-calorie foods such as lean proteins and vegetables, and having smaller portions Swapping empty calories for high-fiber choices such as fruit and whole grains. Suggestions for small changes. Allowances for special occasions and cravings. https://www.ncbi.nlm.nih.gov/pubmed/22812594
  • 10. HEALTHY DPP DIET FOR PREDIABETES FOODS TO LIMIT OR AVOID PROCESSED MEATS FRIED FOODS FATTY RED MEAT AND POULTRY WITH SKIN SOLID FATS (E.G., LARD AND BUTTER) REFINED GRAINS (E.G., WHITE BREAD, PASTA, RICE, AND CRACKERS, AND REFINED CEREALS) SWEETS (E.G., CANDY, CAKE, ICE CREAM, PIE, PASTRIES, AND COOKIES) SUGAR-SWEETENED BEVERAGES, (E.G., SOFT DRINKS, ENERGY DRINKS, SPORTS DRINKS, AND SUGAR-SWEETENED COFFEE AND TEA BEVERAGES) ALCOHOLIC BEVERAGES AND MIXED DRINKS SUGAR-SWEETENED FOODS, SUCH AS FLAVORED YOGURT AND OATMEAL, AND SUGARY CONDIMENTS DRIED FRUIT AND FRUIT JUICE Water and other low-calorie, hydrating beveragES SUCH AS DECAFFEINATED GREEN TEA. CONS IS LESS FOCUSED ON COUNTING CALORIES AND GRAMS OF CARBOHYDRATE, FAT, AND PROTEIN GRAMS . IS NOT A PRESCRIPTIVE MEAL PLAN
  • 11. EXPERIENCE ON DIET Easy to follow Choose from variety of food Cant stick to well crafted plan. Effort to enter data and track Hard to meet Iron Easy to met Vit A, C, Calcium, Potassium High on fiber, low on sodium Weight lost : 遜 pound (62.5- 62.1)
  • 12. Time constraints Low appetite Modifying for whole family Low motivation Data entry Eating out Too many vegetables
  • 13. WAYS TO ADDRESS BARRIERS/CHALLENGES FIND OUT THE MOTIVATION SMALL STEPS AT A TIME FRESH. FROZEN, CANNED ALL COUNTS TOWARDS MEETING DAILY GOAL MENU PLANNING, GROCERY LIST, STOCKING PANTRY. LOGGING ON THE DAYS YOU THINK YOU EAT MORE.

Editor's Notes

  1. .
  2. Though a diet is easy to follow, for me it was a struggle because of the hectic schedule. . I did not like to track the food because it an extra work and takes time and effort in entering data. However, it helped me to see that most of my micro-nutrients need are not meeting.