Introduction
Impaired fasting glucose (IFG) often progresses to
type 2 diabetes. Given the severity and prevalence of this disease, primary
prevention is important. Intensive lifestyle counseling interventions have
delayed or prevented the onset of type 2 diabetes, but it is not known whether
less intensive, more easily replicable efforts can also be effective.
Methods
In a lifestyle intervention study designed to reduce risks
for type 2 diabetes, 200 American Indian women without diabetes, aged 18 to 40
years, were recruited from an urban community without regard to weight or IFG
and block-randomized into intervention and control groups on the basis of
fasting blood glucose (FBG). Dietary and physical activity behaviors were
reported, and clinical metabolic, fitness, and body composition measures were
taken at baseline and at periodic follow-up through 18 months. American Indian
facilitators used a group-discussion format during the first 6 months to deliver
a culturally influenced educational intervention on healthy eating, physical
activity, social support, and goal setting. We analyzed a subset of young
American Indian women with IFG at baseline (n = 42), selected from both the
intervention and control groups.
Results
Among the women with IFG, mean FBG significantly decreased
from baseline to follow-up (P < .001) and converted to normal (<5.6
mmol/L or <100 mg/dL) in 62.0% of the 30 women who completed the 18-month
follow-up, irrespective of participation in the group educational sessions.
Other improved metabolic values included significant decreases in mean fasting
blood total cholesterol and low-density lipoprotein cholesterol levels. The
women reported significant overall mean decreases in intake of total energy,
saturated fat, total fat, total sugar, sweetened beverages, proportion of sweet
foods in the diet, and hours of TV watching.
Conclusion
Volunteers with IFG in this study benefited from
learning their FBG values and reporting their dietary patterns; they made
dietary changes and improved their FBG and lipid profiles. If confirmed in
larger samples, these results support periodic dietary and body composition
assessment, as well as glucose monitoring among women with IFG.