A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes

Abstract Aim To compare the effectiveness and cost of two lifestyle-modification programmes in individuals at high risk of developing type 2 diabetes. Methods Forty-eight men and women with a body mass index ≥27 kg/m2 and prediabetes were randomly assigned to either a 1-year interdisciplinary intervention including individual counseling every 6 weeks and 25 group seminars (group I; n = 22) or a group intervention comprising seminars only (group G; n = 26). These interventions were compared in terms of weight loss and improvement of anthropometric measures, metabolic variables and costs. Results Participants in group I lost an average of 4.9 kg (95% CI: −7.3, −2.4; P < 0.01) and 5 cm in waist circumference (95% CI: −7.0, −3.0; P < 0.01), whereas no significant change was noted in those assigned to group G. Among the participants in group I, 50 and 27% lost at least 5 and 10% of their initial weight, respectively, compared with only 12 and 4%, respectively, in group G. Fasting glucose, 2-hour glucose and lipid profiles improved significantly in group I, and no participant (zero on 22) developed diabetes compared with 11.5% (3/26) in group G. Most participants (nine on 11) with impaired fasting glucose in group I returned to normal. The direct cost of the individual intervention was estimated to be $733.06/year per subject compared with $81.36/year per subject for the group intervention. Conclusion This study demonstrates that a low-cost, moderate-intensity, individual interdisciplinary approach combined with group seminars leads to clinically significant weight loss and metabolic improvement in people with prediabetes. Group seminars alone were not effective in this population ( www.ClinicalTrial.gov , Identifier: NCT00991549 ).