Research Description
People living with prediabetes are advised to lose weight to prevent development of type 2 diabetes by participating in intensive lifestyle interventions (ILI’s), such as PreventT2. The PreventT2 program focuses on a low-calorie diet as a strategy to produce weight loss. However, many individuals find it difficult to stick to a low-calorie diet long-term. The identification of novel, effective and individualized dietary strategies to produce long-term weight loss is critically important in diabetes prevention. An ILI based on PreventT2 which considers individual preferences, allowing participants to choose among a variety of diets, may result in greater adherence to the diet than a standard PreventT2 intervention. ILIs also need to be available to individuals in a wide range of communities, including Americans living in rural communities, who experience higher rates of obesity and chronic disease, yet have less access to medical care, including programs for diabetes prevention. We propose a 12-month pilot and feasibility study of a group-based ILI program based on PreventT2 plus choice of dietary strategy (PreventT2 + Choice) delivered via videoconference to adults with prediabetes living in rural communities. We expect that PreventT2 + Choice will result in increased adherence to the diet and greater improvements in weight and glucose levels as compared to a standard PreventT2 intervention. Successful completion of this project will result in the refinement of an ILI that incorporates personal preferences and is tailored to individuals at high risk for type 2 diabetes living in rural areas where access to such interventions is limited.Research Profile
What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?This project covers the area of prediabetes and prevention of type 2 diabetes. The goal of this project is to modify the most commonly used diabetes prevention program (PreventT2) to include alternative dietary options to daily caloric restriction. We plan to obtain input from stakeholders (individuals living with prediabetes in rural areas of Colorado) in order to modify the curriculum to fit the needs of the target population. We will then pilot test the program (PreventT2 + Choice) in a 16-week intervention delivered virtually to adults with prediabetes living in rural Colorado. We hope that this project will help prevent progression from prediabetes to type 2 diabetes in the program participants. In addition, if we are successful we hope to scale up the project to include a larger number of individuals.
If a person with diabetes were to ask you how your project will help them in the future, how would you respond?Although this project will not enroll individuals with diabetes (only those with prediabetes), this research will result in important information regarding the effects of dietary choice on engagement in a lifestyle intervention. We hypothesize that individuals enrolling in a diabetes prevention program will be more engaged and have better adherence to the diet if they are allowed to choose among several dietary options. This information may lead to additional research in individuals with diabetes, who may also benefit from lifestyle interventions that allow individuals to choose a dietary strategy.
Why important for you, personally, to become involved in diabetes research? What role will this award play?As an adult endocrinologist, I take care of many individuals with type 2 diabetes suffering from the long-term complications of this chronic disease, and I often think about how we might have helped these individuals prevent such complications. Intensive lifestyle interventions focusing on diet, exercise and behavior change have been shown to reduce the risk of progression from prediabetes to type 2 diabetes, yet very few people who might benefit from these programs actually enroll in them. I am passionate about improving and expanding access to diabetes prevention programs so that fewer individuals develop this chronic disease. This award will result in the development of a diabetes prevention program that allows for individual choice of dietary strategy, and will hopefully allow for further testing and expansion of the program in the future.
In what direction do you see the future of diabetes research going?I see diabetes research moving more toward individualization of recommendations, in diabetes prevention, monitoring and treatment. Although it is increasingly recognized that the same approach does not work for all individuals, and the current ADA guidelines recommend that treatment be tailored to patient-specific factors, research on predictors of response to treatment remains limited. I believe this is an area with many opportunities for research and innovation.