Type 2 diabetes (T2DM) is a serious chronic condition and one of the world's fastest growing health problems. The onset of T2DM is gradual, with most individuals progressing through a state of pre-diabetes. Pre-diabetes is a prevalent and potentially reversible condition, which provides an important window of opportunity for the prevention of T2DM and its complications. This project aims to translate the evidence-based diabetes prevention strategies into a community setting to reduce diabetes risks in Hong Kong Chinese people with pre-diabetes .
Type 2 diabetes (T2DM) is a major non-communicable disease and one of the world's fastest growing health problem. It is associated with significant morbidity, including increased risk of heart disease and stroke, hypertension, retinopathy and blindness, renal failure and leg amputation, which place an enormous burden on individuals, society and the healthcare system. The T2DM trend in Hong Kong mirrors the global trend. It is a major cause of mortality and morbidity with approximately 700,000 people diagnosed with diabetes, representing 10% of Hong Kong's total population. T2DM is a non-reversible, yet a preventable condition. The onset of T2DM is gradual, with most individuals progressing through a state of pre-diabetes. People with pre-diabetes, defined as having impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or elevated glycated haemoglobulin (HbA1C) , are at increased risk of developing T2DM and its associated complications, such as heart diseases and retinopathy, which can develop even in the absence of progression to overt T2DM. Hence, it is essential that people with pre-diabetes are targeted for early intervention to prevent T2DM and related complications. International clinical trials demonstrated that lifestyle interventions targeting at least 5% weight loss in individuals with pre-diabetes can be cost-effective in preventing T2DM. Lifestyle intervention (which includes diet, physical activity and behavioural modification components) and self-management of pre-diabetes has been listed as an effective means of decreasing the incidence of T2DM in the international guidelines on management of pre-diabetes. The aim of this study is to translate preventive research into effective community-based intervention by setting up a culturally appropriate lifestyle intervention programme for the prevention of T2DM in Hong Kong Chinese adults with pre-diabetes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Involve education about pre-diabetes self-management, weight loss, behavioural modification skills, nutrition and physical activity.
Text message related to general information about T2DM, pre-diabetes, and lifestyle modification.
The University of Hong Kong
Hong Kong, Hong Kong
Percent weight change
% weight change from baseline
Time frame: % weight change from baseline at 6-month and 12-months
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)
Estimated from fasting insulin and fasting glucose, \[fasting insulin (uU/mL)\*fasting glucose(mmol/L)\]/22.5
Time frame: Changes from baseline insulin sensitivity at 6-month and 12-months
Fasting insulin
Fasting insulin
Time frame: Changes from baseline fasting insulin at 6-month and 12-months
Fasting blood glucose (FG)
Fasting blood glucose
Time frame: Changes from baseline FG at 6-month and 12-months
Haemoglobin A1C (HbA1C)
HbA1C
Time frame: Changes from baseline HbA1Cat 6-month and 12-months
Systolic and diastolic blood pressure (SBP, DBP)
measured by automatic BP monitor
Time frame: Changes from baseline SBP and DBP at 6-month and 12-months
Blood lipid profile
fasting blood for total cholesterol, HDL, LDL and triglycerides
Time frame: Changes from baseline blood lipid to 6-month and 12-months
Diabetes status
Oral glucose tolerance test
Time frame: 6-month and 12-months follow-up
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Purpose
PREVENTION
Masking
SINGLE
Enrollment
180
Physical activity
International physical activity questionnaire short form (IPAQ, Chinese version). A validated 6-item questionnaire to assess the frequency and duration of vigorous intensity activity, moderate intensity activity, and walking. The questionnaire will be scored using established methods (www.ipaq.ki.se). Data will be summarized to report physical activity in categories: 1. High-active group * Vigorous-intensity activity on ≥ 3 days and accumulating ≥1500 MET-minutes/week OR * ≥7 days of any combination of walking, moderate-intensity or vigorous intensity activities achieving ≥3000 MET-minutes/week 2. Moderate-active group * ≥3 days of vigorous activity of ≥20 minutes/day OR * ≥5 days of moderate-intensity activity or walking of ≥30 minutes/day OR * ≥5 days of any combination of walking, moderate-intensity or vigorous intensity activities achieving ≥600 MET-min/week. 3. Low-active/inactive group Individuals who do not meet criteria for high- and moderate-active
Time frame: Change in levels of physical activity from baseline to 6-month and 12-months
Dietary intake
24 hour recalls
Time frame: Changes in dietary intake from baseline to 6-month and 12-months
Health-related quality of life (HRQOL)
12-item Short Form Survey (SF12 Chinese version). It is a validated scale which provides two summary measures. Physical and Mental Health Composite Scores (PCS \& MCS) will be computed using the scores of 12 questions and range from 0 to 100. Higher scores represent better health.
Time frame: Changes in HRQOL from baseline to 6-month and 12-months
Carotid artery intima-media thickness (cIMT)
High-resolution B-mode ultrasonography
Time frame: Change in cIMT from baseline to 6-month and 12-months