PDM: Prediabetes (2013)

PDM: Prediabetes (2013)

• Assessment
  In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?

  • Conclusion

    The majority of lifestyle modification intervention studies reported that weight loss significantly reduces fasting blood glucose in individuals with prediabetes, while most studies report no significant impact of weight loss on two-hour post-prandial blood glucose or A1C.

    Of those studies reporting a weight loss ranging from 2.6 to 7.1kg, there was a significant reduction in fasting blood glucose levels by 2.2 to 9.2mg per dL (0.12 to 0.5mmol per L).

    In bariatric surgery intervention studies, a weight loss of up to 47kg or 41% of excess BMI over a period of three to five years significantly reduced fasting glucose levels by 16.2 to 20.9mg per dL (0.9 to 1.16mmol per L), two-hour glucose levels by 16mg per dL (0.9mmol per L) and A1C by 0.5%.

    Additional lifestyle modification intervention studies are needed to ascertain the effects of weight loss on two-hour post-prandial blood glucose and A1C in individuals with prediabetes.

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on glycemic-related outcomes (such as fasting blood glucose, random blood glucose, two-hour post-prandial blood glucose, A1C)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Allen P, Thompson JL, Herman CJ, Qualls C, Helitzer DL, Whyte AN, Wolfe VK. Impact of periodic follow-up testing among urban American Indian women with impaired fasting glucose. Prev Chronic Dis. 2008; 5(3): A76.
      • Burtscher M, Gatterer H, Kunczicky H, Brandstatter E, Ulmer H. Supervised exercise in patients with impaired fasting glucose: Impact on exercise capacity. Clin J. Sport Med. 2009; 19 (5): 394-398.
      • Caiazzo R, Arnalsteen L, Pigeyre M, Dezfoulian G, Verkindt G, Kirkby-Bott J, Mathurin P, Fontaine P, Romon M, Pattou F. Long-term metabolic outcome and quality of life after laparoscopic adjustable gastric banding in obese patients with type 2 diabetes mellitus or impaired fasting glucose. Br J Surg. 2010; 97(6): 884-891.
      • de la Cruz-Munoz N, Messiah SE, Arheart KL, Lopez-Mitnik G, Lipshultz SE, Livingstone A. Bariatric surgery significantly decreases the prevalence of type 2 diabetes mellitus and pre-diabetes among morbidly obese multiethnic adults: long-term results. J Am Coll Surg. 2011; 212(4): 505-511.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Katula JA, Vitolins MZ, Rosenberger EL, Blackwell CS, Morgan TM, Lawlor MS, Goff DC Jr. One-year results of a community-based translation of the Diabetes Prevention Program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project. Diabetes Care. 2011; 34(7): 1,451-1,457.
      • Lu YH, Lu JM, Wang SY, Li CL, Zheng RP, Tian H, Wang XL. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China. Adv Ther. 2011; 28(6): 511-519.
      • Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roque i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008 Jul; (3): CD003054.
      • Parikh P, Simon EP, Fei K, Looker H, Goytia C, Horowitz CR. Results of a pilot diabetes prevention program intervention in East Harlem, New York City: Project HEED. Am J Public Health. 2010; 100 Suppl 1: S232-S239.
      • Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tsuzaki K, Tominaga M, Kawazu S, Sato Y, Usui T, Kamae I, Yoshida T, Kiyohara Y, Sato S, Kuzuya H, Japan Diabetes Prevention Program (JDPP) Research Group. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance. BMC Public Health. 2011; 11(1): 40.
  • Search Plan and Results: PDM: Weight Loss and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on lipid outcomes (TG, HDL)?

  • Conclusion

    Most lifestyle modification intervention studies reported that weight loss improves triglyceride levels, but does not have a significant impact on HDL-cholesterol levels, in individuals with prediabetes.

    In the study reporting a weight loss of 2.7kg, there was a significant reduction in triglyceride levels by 30.9mg per dL (0.35mmol per/L).

    In one bariatric surgery intervention study, a weight loss of up to 41% of excess BMI significantly decreased triglyceride levels by 70.6 mg/dL (0.8mmol per L) and increased HDL-cholesterol levels by 1.9mg per dL (0.05mmol per L).

    Additional lifestyle modification intervention studies are needed to ascertain the effects of weight loss on lipid outcomes in individuals with prediabetes.

     

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of weight loss (over at least a 3-month period) on lipid outcomes (TG, HDL)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Allen P, Thompson JL, Herman CJ, Qualls C, Helitzer DL, Whyte AN, Wolfe VK. Impact of periodic follow-up testing among urban American Indian women with impaired fasting glucose. Prev Chronic Dis. 2008; 5(3): A76.
      • Burtscher M, Gatterer H, Kunczicky H, Brandstatter E, Ulmer H. Supervised exercise in patients with impaired fasting glucose: Impact on exercise capacity. Clin J. Sport Med. 2009; 19 (5): 394-398.
      • Caiazzo R, Arnalsteen L, Pigeyre M, Dezfoulian G, Verkindt G, Kirkby-Bott J, Mathurin P, Fontaine P, Romon M, Pattou F. Long-term metabolic outcome and quality of life after laparoscopic adjustable gastric banding in obese patients with type 2 diabetes mellitus or impaired fasting glucose. Br J Surg. 2010; 97(6): 884-891.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Lu YH, Lu JM, Wang SY, Li CL, Zheng RP, Tian H, Wang XL. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China. Adv Ther. 2011; 28(6): 511-519.
      • Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roque i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008 Jul; (3): CD003054.
      • Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tsuzaki K, Tominaga M, Kawazu S, Sato Y, Usui T, Kamae I, Yoshida T, Kiyohara Y, Sato S, Kuzuya H, Japan Diabetes Prevention Program (JDPP) Research Group. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance. BMC Public Health. 2011; 11(1): 40.
  • Search Plan and Results: PDM: Weight Loss and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on anthropometric outcomes (WC, WHR)?

  • Conclusion

    The majority of lifestyle modification intervention studies reported that weight loss significantly reduces waist circumference, but does not have a significant impact on waist-to-hip ratio, in individuals with prediabetes.

    Of those studies reporting a weight loss ranging from 2.7 to 7.1kg, there was a significant reduction in waist circumference by 1.3 to 5.9cm.

     

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of weight loss (over at least a 3-month period) on anthropometric outcomes (WC, WHR)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Allen P, Thompson JL, Herman CJ, Qualls C, Helitzer DL, Whyte AN, Wolfe VK. Impact of periodic follow-up testing among urban American Indian women with impaired fasting glucose. Prev Chronic Dis. 2008; 5(3): A76.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Katula JA, Vitolins MZ, Rosenberger EL, Blackwell CS, Morgan TM, Lawlor MS, Goff DC Jr. One-year results of a community-based translation of the Diabetes Prevention Program: Healthy-Living Partnerships to Prevent Diabetes (HELP PD) Project. Diabetes Care. 2011; 34(7): 1,451-1,457.
      • Lu YH, Lu JM, Wang SY, Li CL, Zheng RP, Tian H, Wang XL. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China. Adv Ther. 2011; 28(6): 511-519.
      • Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roque i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008 Jul; (3): CD003054.
      • Parikh P, Simon EP, Fei K, Looker H, Goytia C, Horowitz CR. Results of a pilot diabetes prevention program intervention in East Harlem, New York City: Project HEED. Am J Public Health. 2010; 100 Suppl 1: S232-S239.
      • Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tsuzaki K, Tominaga M, Kawazu S, Sato Y, Usui T, Kamae I, Yoshida T, Kiyohara Y, Sato S, Kuzuya H, Japan Diabetes Prevention Program (JDPP) Research Group. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance. BMC Public Health. 2011; 11(1): 40.
  • Search Plan and Results: PDM: Weight Loss and Prediabetes 2012
     
  In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on blood pressure?

  • Conclusion

    Most lifestyle modification intervention studies reported that weight loss significantly reduces systolic and diastolic blood pressure in individuals with prediabetes.

    Of those studies reporting a weight loss ranging from 2.7kg to 4.9kg, there was a significant reduction in systolic blood pressure of 3.5mm Hg to 6mm Hg and in diastolic blood pressure of 5mm Hg.

    In one bariatric surgery intervention study, a weight loss of up to 41% of excess BMI significantly reduced systolic blood pressure by 6mm Hg.

     

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In individuals with prediabetes, what is the impact of weight loss (over at least a three-month period) on blood pressure?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Allen P, Thompson JL, Herman CJ, Qualls C, Helitzer DL, Whyte AN, Wolfe VK. Impact of periodic follow-up testing among urban American Indian women with impaired fasting glucose. Prev Chronic Dis. 2008; 5(3): A76.
      • Burtscher M, Gatterer H, Kunczicky H, Brandstatter E, Ulmer H. Supervised exercise in patients with impaired fasting glucose: Impact on exercise capacity. Clin J. Sport Med. 2009; 19 (5): 394-398.
      • Caiazzo R, Arnalsteen L, Pigeyre M, Dezfoulian G, Verkindt G, Kirkby-Bott J, Mathurin P, Fontaine P, Romon M, Pattou F. Long-term metabolic outcome and quality of life after laparoscopic adjustable gastric banding in obese patients with type 2 diabetes mellitus or impaired fasting glucose. Br J Surg. 2010; 97(6): 884-891.
      • Gagnon C, Brown C, Couture C, Kamga-Ngande CN, Hivert MF, Baillargeon JP, Carpentier AC, Langlois MF. A cost-effective moderate-intensity interdisciplinary weight-management programme for individuals with prediabetes. Diabetes Metab. 2011; 37(5): 410-418.
      • Lu YH, Lu JM, Wang SY, Li CL, Zheng RP, Tian H, Wang XL. Outcome of intensive integrated intervention in participants with impaired glucose regulation in China. Adv Ther. 2011; 28(6): 511-519.
      • Orozco LJ, Buchleitner AM, Gimenez-Perez G, Roque i Figuls M, Richter B, Mauricio D. Exercise or exercise and diet for preventing type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008 Jul; (3): CD003054.
      • Parikh P, Simon EP, Fei K, Looker H, Goytia C, Horowitz CR. Results of a pilot diabetes prevention program intervention in East Harlem, New York City: Project HEED. Am J Public Health. 2010; 100 Suppl 1: S232-S239.
      • Sakane N, Sato J, Tsushita K, Tsujii S, Kotani K, Tsuzaki K, Tominaga M, Kawazu S, Sato Y, Usui T, Kamae I, Yoshida T, Kiyohara Y, Sato S, Kuzuya H, Japan Diabetes Prevention Program (JDPP) Research Group. Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance. BMC Public Health. 2011; 11(1): 40.
  • Search Plan and Results: PDM: Weight Loss and Prediabetes 2012