Reuters Events | Pharma

Thought leadership and innovation for the Pharmaceutical Industry

Community programmes could be equally effective in the long term to clinical iniatives in preventing type II diabetes, a US study has recently highlighted

By Anonymous on Mar 18, 2013

Recent research by the Wake Forest Baptist Medical Centre (published in the American Journal of Preventative Medicine) supports an original study by the National Institutes of Health’s Diabetes Prevention Programme (DPP).

This original study was a randomised clinical trial on a large scale that used around 3,200 adults from more than 27 different clinics in the US. Participants were divided into three groups which either incorporated rigorous lifestyle changes such exercising regularly or receiving conventional medical care. The two groups receiving standard medical care reduced their chance of developing diabetes by 31% while the group who underwent lifestyle changes lessened their likelihood by 58%.

Following this, the Wake Forest study demonstrated that these preventative lifestyle changes for diabetes could be as effective when delivered in a community setting by community health workers rather than in clinical surroundings with doctors. These researchers looked at the outcomes of a lifestyle weight-loss programme involving 301 participants with elevated fasting blood glucose, a precondition of diabetes, for around 24 months. Participants were put in a group that focused on a weight-loss lifestyle intervention or traditional medical care for the prevention of diabetes.

Findings demonstrate that 46.5% participants who were in the group exposed to lifestyle changes lost 5% of their body weight and thus lowered their risk of type II diabetes. Only 15% of those in the traditional medical care lost 5% of their body weight, even with doctors advising them on the benefits of lifestyle changes.

Latest estimates state that about 26 million people in the US have diabetes, while a further 79 million adults have prediabetes-  a higher rate of blood glucose levels but, not high enough to be diagnosed as diabetes. The public health burden of diabetes continues to increase even though treatment for the disease has improved over the past few years. This highlights the importance of prevention in healthcare whilst demonstrating that preventative techniques for diseases are not used often.

The study’s main author and assistant professor at of health and exercise sciences at Wake Forest University Jeff Katula said, “We wanted to take this intervention out to people in the community rather than having them have to come to us in a clinical setting. Given the high prevalence of obesity and metabolic syndrome and risk for diabetes, our study shows we can provide an effective program in a community setting. Many previous studies have shown that people can lose weight for six months, but maintaining those changes, particularly metabolic changes, over time is the real challenge.”

If preventative programmes can be delivered effectively by community healthcare stakeholders, such as pharmacists or health workers, the burden of delivering treatment options for patients is not solely on clinical professionals such as doctors. Pharmaceutical companies could educate these community professionals to deliver better care in the long term. The real-world evidence from this relationship could then be used to develop better treatment, whether medical or lifestyle-based, for the future.