A pragmatic lifestyle modification programme reduces the incidence of predictors of cardio-metabolic disease and dysglycaemia in a young healthy urban South Asian population:a randomised controlled trial

Autor: Wijesuriya, Mahen, Fountoulakis, Nikolaos, Guess, Nicola, Banneheka, Sarath, Vasantharajah, Laksha, Gulliford, Martin, Viberti, Giancarlo, Gnudi, Luigi, Karalliedde, Janaka
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Zdroj: Wijesuriya, M, Fountoulakis, N, Guess, N, Banneheka, S, Vasantharajah, L, Gulliford, M, Viberti, G, Gnudi, L & Karalliedde, J 2017, ' A pragmatic lifestyle modification programme reduces the incidence of predictors of cardio-metabolic disease and dysglycaemia in a young healthy urban South Asian population : a randomised controlled trial ', BMC Medicine, vol. 15, no. 1, 146 . https://doi.org/10.1186/s12916-017-0905-6
BMC Medicine, Vol 15, Iss 1, Pp 1-10 (2017)
BMC Medicine
DOI: 10.1186/s12916-017-0905-6
Popis: Background There is an increasing incidence of type 2 diabetes mellitus (T2DM) in young urban South-Asians. We tested the effect of a pragmatic trimonthly lifestyle modification (LSM) programme (P-LSM) versus a less-intensive 12-monthly control LSM (C-LSM) intervention on a primary composite endpoint of predictors of cardio-metabolic disease (new onset T2DM, hypertension, impaired glucose tolerance (IGT), impaired fasting glycaemia (IFG) and markers of cardio-renal disease) in participants aged 5–40 years with risk factors for T2DM. Methods This was a randomised controlled trial performed at the National Diabetes Centre, Sri-Lanka. We individually randomised 4672 participants at risk of T2DM, of whom 3539 (mean age 22.5 (range 6–40 years, 48% males) received either trimonthly (P-LSM n = 1726) or 12-monthly (C-LSM n = 1813) peer educator advice aimed at reducing weight, improving diet, reducing psychological stress and increasing physical activity. Results During a median follow-up of 3 years, the cumulative incidence of the primary endpoint was n = 479 in P-LSM (74 per 1000 person years) vs. 561 in C-LSM (96 per 1000 person years), with an incident rate ratio (IRR) of 0.89 (95% CI 0.83–0.96, P = 0.02). In post hoc analyses, new onset dysglycaemia (T2DM, IFG and IGT), was the major contributor to the composite and was significantly reduced by P-LSM (IRR 0.9, 95% CI 0.83–0.97, P = 0.01). A significant impact of P-LSM on the incidence of the composite endpoint was noted in 1725 participants (P-LSM n = 850, C-LSM n = 875) aged below 18; P-LSM n = 140 (48 per 1000 person years) versus C-LSM n = 174 (55.4 per 1000 person years), with an IRR of 0.83 (95% CI 0.73–0.94, P = 0.004). Conclusions In a young at-risk South-Asian population, a pragmatic LSM programme significantly reduces the incidence of predictors of cardio-metabolic disease. Our results highlight the importance of early intervention in young at-risk subjects. Trial registration World Health Organization international clinical trial registry platform (SLCTR/2008/003). Registration Date: March 28, 2008. Retrospectively registered. Electronic supplementary material The online version of this article (doi:10.1186/s12916-017-0905-6) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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