Effect of Conventional Lifestyle Interventions on Type 2 Diabetes Incidence by Glucose-Defined Prediabetes Phenotype: An Individual Participant Data Meta-analysis of Randomized Controlled Trials.

IF 14.8 1区医学 Q1 ENDOCRINOLOGY & METABOLISM Diabetes Care Pub Date : 2023-11-01 DOI:10.2337/dc23-0696

Thirunavukkarasu Sathish, Kamlesh Khunti, K M Venkat Narayan, Viswanathan Mohan, Melanie J Davies, Thomas Yates, Brian Oldenburg, Kavumpurathu R Thankappan, Robyn J Tapp, Ram Bajpai, Ranjit Mohan Anjana, Mary B Weber, Mohammed K Ali, Jonathan E Shaw

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Abstract

Objective: To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by glucose-defined prediabetes phenotype.

Research design and methods: We searched multiple databases until 1 April 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and impaired fasting glucose plus impaired glucose tolerance (IFG+IGT). Individual participant data were pooled from relevant trials and analyzed through random-effects models with use of the within-trial interactions approach.

Results: Four trials with 2,794 participants (mean age 53.0 years, 60.7% men) were included: 1,240 (44.4%), 796 (28.5%), and 758 (27.1%) had i-IFG, i-IGT, and IFG+IGT, respectively. After a median of 2.5 years, the pooled hazard ratio for diabetes incidence in i-IFG was 0.97 (95% CI 0.66, 1.44), i-IGT 0.65 (0.44, 0.96), and IFG+IGT 0.51 (0.38, 0.68; Pinteraction = 0.01).

Conclusions: Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.

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通过葡萄糖定义的糖尿病前期表型，常规生活方式干预对2型糖尿病发病率的影响：随机对照试验的个体参与者数据荟萃分析。

目的：研究传统生活方式干预对2型糖尿病发病率的影响是否因葡萄糖定义的糖尿病前期表型而异。研究设计和方法：我们在多个数据库中搜索了截至2023年4月1日的随机对照试验，这些试验招募了患有孤立性空腹血糖受损（i-IFG）、孤立性糖耐量受损（i-IGT）和空腹血糖受损加糖耐量损伤（IFG+IGT）的人。个体参与者的数据来自相关试验，并使用试验内相互作用方法通过随机效应模型进行分析。结果：包括四项试验，共有2794名参与者（平均年龄53.0岁，男性60.7%）：分别有1240人（44.4%）、796人（28.5%）和758人（27.1%）患有i-IFG、i-IGT和IFG+IGT。中位2.5年后，i-IFG糖尿病发病率的合并危险比为0.97（95%CI 0.66，1.44），i-IGT 0.65（0.44，0.96），IFG+IGT 0.51（0.38，0.68；Pinteract=0.01）。

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.