3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 1\/8<\/p>\n
Systematic Review<\/p>\n
Topic Diabetes, Obesity<\/p>\n
Recommended (suf\ufffdcient evidence)<\/p>\n
Audience Adults, Older Adults<\/p>\n
Setting Clinical\/Health Systems, Community<\/p>\n
Strategy Counseling, Health Education<\/p>\n
Diabetes Management: Intensive Lifestyle Interventions for Patients with Type 2 Diabetes<\/p>\n
October 2016: 2024 – Do my homework – Help write my assignment online<\/p>\n
This webpage summarizes information available in the CPSTF Findings and Rationale Statement, located under the Snapshot tab.<\/p>\n
The Community Guide (https:\/\/www.thecommunityguide.org)<\/p>\n
Homework help – Summary of CPSTF Finding<\/p>\n
The Community Preventive Services Task Force (CPSTF) recommends intensive lifestyle interventions for<\/p>\n
patients with type 2 diabetes to improve glycemic control and reduce risk factors for cardiovascular<\/p>\n
disease.<\/p>\n
Intervention<\/p>\n
CPSTF Finding and Rationale Statement<\/p>\n
Intensive lifestyle interventions provide ongoing counseling, coaching, or individualized guidance to<\/p>\n
patients with type 2 diabetes to help them change their diet, level of physical activity, or both. Patients<\/p>\n
must interact with program staff multiple times for a period of six months or longer.<\/p>\n
Dietary components may include tailored advice, and physical activity components may include<\/p>\n
structured and personalized guidance or supervised exercise training. Programs may have weight loss<\/p>\n
goals or include additional components related to weight loss or maintenance.<\/p>\n
The largest and longest trial to date provided intensive individual and group counseling and extended<\/p>\n
interpersonal support for dietary changes, regular physical activity, and weight management.<\/p>\n
https:\/\/www.thecommunityguide.org\/topic\/diabetes
\nhttps:\/\/www.thecommunityguide.org\/topic\/obesity
\nhttps:\/\/www.thecommunityguide.org\/
\nhttps:\/\/www.thecommunityguide.org\/task-force\/about-community-preventive-services-task-force
\nhttps:\/\/www.thecommunityguide.org\/task-force\/understanding-task-force-findings-and-recommendations
\n3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 2\/8<\/p>\n
Read the full CPSTF Finding and Rationale Statement [PDF – 793 KB] for details including implementation<\/p>\n
issues, possible added benefits, potential harms, and evidence gaps.<\/p>\n
Promotional Materials<\/p>\n
Community Guide News<\/p>\n
One Pager:<\/p>\n
Users who viewed this also viewed<\/p>\n
About The Systematic Review<\/p>\n
Homework help – Summary of Results<\/p>\n
Intensive Lifestyle Interventions Reduce Cardiovascular Risk Among People with Type 2 Diabetes<\/p>\n
Intensive Lifestyle Interventions for Patients with Type 2 Diabetes<\/p>\n
Mental Health: Targeted School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and<\/p>\n
Anxiety Symptoms<\/p>\n
Violence Prevention: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence<\/p>\n
and Sexual Violence Among Youth<\/p>\n
Diabetes Prevention: Interventions Engaging Community Health Workers<\/p>\n
The CPSTF uses recently published systematic reviews to conduct accelerated assessments of<\/p>\n
interventions that could provide program planners and decision-makers with additional, effective<\/p>\n
options. The following published review was selected and evaluated by a team of specialists in<\/p>\n
systematic review methods, and in research, practice, and policy related to diabetes management<\/p>\n
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2<\/p>\n
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.<\/p>\n
The systematic review and meta-analysis included 17 studies (Huang et al., 2016: 2024 – Do my homework – Help write my assignment online; search period<\/p>\n
through July 15, 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). The CPSTF finding is based on results from a subset of 7 studies that evaluated<\/p>\n
intensive physical activity programs (5 studies) and intensive dietary programs (3 studies) in addition<\/p>\n
to expert input from team members and the CPSTF. The largest and longest study (Look AHEAD trial)<\/p>\n
evaluated both intensive dietary and physical activity programs.<\/p>\n
https:\/\/www.thecommunityguide.org\/sites\/default\/files\/assets\/Diabetes-Lifestyle-Interventions.pdf
\nhttps:\/\/www.thecommunityguide.org\/content\/intensive-lifestyle-interventions-reduce-cardiovascular-risk-among-people-type-2-diabetes
\nhttps:\/\/www.thecommunityguide.org\/resources\/one-pager-intensive-lifestyle-interventions-patients-type-2-diabetes
\nhttps:\/\/www.thecommunityguide.org\/findings\/mental-health-targeted-school-based-cognitive-behavioral-therapy-programs-reduce-depression-anxiety-symptoms
\nhttps:\/\/www.thecommunityguide.org\/findings\/violence-prevention-primary-prevention-interventions-reduce-perpetration-intimate-partner-violence-sexual-violence-among-youth
\nhttps:\/\/www.thecommunityguide.org\/findings\/diabetes-prevention-interventions-engaging-community-health-workers
\n3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 3\/8<\/p>\n
Homework help – Summary of Economic Evidence<\/p>\n
Huang et al. did not consider evidence or information on the economic benefits of these interventions.<\/p>\n
An economic evaluation of the Look AHEAD trial reported lower health-care costs over 10 years.<\/p>\n
Applicability<\/p>\n
Based on evidence from the review, the CPSTF finding is applicable to interventions offered to adults<\/p>\n
with type 2 diabetes through healthcare settings in the United States.<\/p>\n
Evidence Gaps<\/p>\n
Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF –<\/p>\n
793 KB].<\/p>\n
The systematic review included 7 studies. The largest and longest study (Look AHEAD trial) evaluated<\/p>\n
both intensive dietary and physical activity programs.<\/p>\n
Dietary Programs (3 studies)<\/p>\n
Intensive dietary programs led to favorable changes in reported outcomes.<\/p>\n
Body Mass Index: non-significant decrease<\/p>\n
Blood glucose (A1c): significant decrease<\/p>\n
Systolic blood pressure: significant decrease<\/p>\n
Diastolic blood pressure: significant decrease<\/p>\n
LDL cholesterol: non-significant decrease<\/p>\n
HDL cholesterol: significant increase<\/p>\n
Physical Activity Programs (5 studies)<\/p>\n
Intensive physical activity programs led to favorable changes in reported outcomes.<\/p>\n
Body Mass Index: non-significant decrease<\/p>\n
Blood glucose (A1c): significant decrease<\/p>\n
Systolic blood pressure: non-significant decrease<\/p>\n
Diastolic blood pressure: significant decrease<\/p>\n
LDL cholesterol: non-significant decrease<\/p>\n
HDL cholesterol: non-significant increase<\/p>\n
https:\/\/www.thecommunityguide.org\/sites\/default\/files\/assets\/Diabetes-Lifestyle-Interventions.pdf
\n3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 4\/8<\/p>\n
Study Characteristics<\/p>\n
Analytic Framework<\/p>\n
No content is available for this section.<\/p>\n
Homework help – Summary Evidence Table<\/p>\n
A summary evidence table for this Community Guide review is not available because the CPSTF finding<\/p>\n
is based on the following published systematic review:<\/p>\n
The CPSTF identified several areas that have limited information. Additional research and evaluation<\/p>\n
could help answer the following questions and fill remaining gaps in the evidence base. (What are<\/p>\n
evidence gaps?)<\/p>\n
How does effectiveness vary between specific programs in different populations (e.g., by race,<\/p>\n
SES, educational attainment, age, cognitive or physical disabilities)?<\/p>\n
How effective are programs delivered through the internet, email, apps, or social networking?<\/p>\n
What is the relative effectiveness of individual and group sessions?<\/p>\n
What structures and systems are needed to maintain program effectiveness and help participants<\/p>\n
continue their improvements to diet and physical activity following program completion?<\/p>\n
What are long-term effects on participants\u2019 glycemic control, weight loss, cardiovascular disease<\/p>\n
risk factors, morbidity, and mortality?<\/p>\n
What are program attrition rates? Why do participants drop out, and how can they be retained?<\/p>\n
Are these interventions effective with children and adolescents?<\/p>\n
All included studies were randomized controlled trials.<\/p>\n
Evaluated interventions provided a median of 11 sessions that were individual (3 studies) or a<\/p>\n
combination of individual and group sessions (4 studies).<\/p>\n
Studies evaluated interventions that provided patients specific, tailored instruction on lifestyle<\/p>\n
changes through multiple interactions over extended periods of time.<\/p>\n
Four of the programs provided additional, extended telephone contact and 2 of the programs had<\/p>\n
frequent, ongoing contact with patients through regular exercise sessions.<\/p>\n
The median intervention duration was 12 months. All 7 studies established clear goals for<\/p>\n
patients\u2019 dietary changes (3 studies), physical activity levels (5 studies), or weight loss (2 studies).<\/p>\n
https:\/\/www.thecommunityguide.org\/about\/evidence-gaps
\n3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 5\/8<\/p>\n
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2<\/p>\n
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.<\/p>\n
Get custom essay samples and course-specific study resources via\u00a0course hero homework for you service – Include d Studies<\/p>\n
The number of studies and publications do not always correspond (e.g., a publication may include several studies<\/p>\n
or one study may be explained in several publications).<\/p>\n
Effectiveness Review<\/p>\n
Studies from Huang et al. (2016: 2024 – Do my homework – Help write my assignment online) Get custom essay samples and course-specific study resources via\u00a0course hero homework for you service – Include d in this Review<\/p>\n
Ali M, Schifano F, Robinson P, Phillips G, Doherty L, Melnick P, et al. Impact of community pharmacy<\/p>\n
diabetes monitoring and education programme on diabetes management: a randomized controlled<\/p>\n
study. Diabet Med 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;29(9):e326\u201333.<\/p>\n
Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al. Effect of an intensive exercise<\/p>\n
intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes<\/p>\n
mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;170:1794\u2013803.<\/p>\n
Chan CW, Siu SC, Wong CK, Lee VW. A pharmacist care program: positive impact on cardiac risk in<\/p>\n
patients with type 2 diabetes. J Cardiovasc Pharmacol Ther 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;17:57\u201364.<\/p>\n
Coppell KJ, KataokaM, Williams SM, Chisholm AW, Vorgers SM, Mann JI. Nutritional intervention in<\/p>\n
patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment\u2014Lifestyle<\/p>\n
Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial. BMJ 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;341:c3337.<\/p>\n
Crasto W, Jarvis J, Khunti K, Skinner TC, Gray LJ, Brela J, et al. Multifactorial intervention in individuals<\/p>\n
with type 2 diabetes and microalbuminuria: the Microalbuminuria Education and Medication<\/p>\n
Optimisation (MEMO) study. Diabetes Res Clin Pract 2011;93: 328\u201336.<\/p>\n
Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM,Wang NY, et al. Effect of exercise on blood<\/p>\n
pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;27:1453\u20139.<\/p>\n
Ko GT, Li JK, Kan EC, LoMK. Effects of a structured health education programme by a diabetic education<\/p>\n
nurse on cardiovascular risk factors in Chinese type 2 diabetic patients: a 1-year prospective<\/p>\n
randomized study. Diabet Med 2004;21:1274\u20139.<\/p>\n
Kirk A, Mutrie N, MacIntyre P, Fisher M. Effects of a 12-month physical activity counselling<\/p>\n
intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2<\/p>\n
diabetes. Diabetologia 2004;47:821\u201332.<\/p>\n
Krein SL, Klamerus ML, Vijan S, Lee JL, Fitzgerald JT, Pawlow A, et al. Case management for patients<\/p>\n
with poorly controlled diabetes: a randomized trial. Am J Med 2004;116:732\u20139.<\/p>\n
3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
https:\/\/www.thecommunityguide.org\/findings\/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 6\/8<\/p>\n
Search Strategies<\/p>\n
Refer to the existing systematic review for information about the search strategy:<\/p>\n
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2<\/p>\n
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.<\/p>\n
Review References<\/p>\n
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2<\/p>\n
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37-47.<\/p>\n
Considerations for Implementation<\/p>\n
Look ARG, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk<\/p>\n
factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch<\/p>\n
Intern Med 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;170:1566\u201375.<\/p>\n
Mohamed H, Al-Lenjawi B, Amuna P, Zotor F, Elmahdi H. Culturally sensitive patient-centred<\/p>\n
educational programme for self-management of type 2 diabetes: a randomized controlled trial. Prim<\/p>\n
Care Diabetes 2013;7:199\u2013206.<\/p>\n
Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martin-Madrazo<\/p>\n
C, Rodes-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level<\/p>\n
of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes<\/p>\n
mellitus. BMC Public Health 2011;11:267.<\/p>\n
Sevick MA, Korytkowski M, Stone RA, Piraino B, Ren D, Sereika S, et al. Biophysiologic outcomes of the<\/p>\n
Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial. J Acad Nutr Diet 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;112:1147\u201357.<\/p>\n
Sone H, Tanaka S, Iimuro S, Tanaka S, Oida K, Yamasaki Y, et al. Long-term lifestyle intervention<\/p>\n
lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre<\/p>\n
randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;53:419\u201328.<\/p>\n
Trento M, Passera P, Bajardi M, Tomalino M, Grassi G, Borgo E, et al. Lifestyle intervention by group<\/p>\n
care prevents deterioration of type II diabetes: a 4-year randomized controlled clinical trial.<\/p>\n
Diabetologia 2002;45:1231\u20139.<\/p>\n
Uusitupa M, Laitinen J, Siitonen O, Vanninen E, Pyorala K. The maintenance of improved metabolic<\/p>\n
control after intensified diet therapy in recent type 2 diabetes. Diabetes Res Clin Pract 1993;19:227\u201338.<\/p>\n
Wisse W, Boer Rookhuizen M, de Kruif MD, van Rossum J, Jordans I, ten Cate H, et al. Prescription of<\/p>\n
physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2<\/p>\n
diabetes patients. Diabetes Res Clin Pract 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;88:e10\u20133.<\/p>\n
3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
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Crosswalks<\/p>\n
Healthy People 2030<\/p>\n
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.<\/p>\n
The following considerations are drawn from studies included in the evidence review, the broader<\/p>\n
literature, and expert opinion.<\/p>\n
The U.S. Preventive Services Task Force (USPSTF) issued the following in 2015 – Research Paper Writing Help Service:<\/p>\n
The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose as part of<\/p>\n
cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should<\/p>\n
offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to<\/p>\n
promote a healthful diet and physical activity. (B recommendation: October 2015 – Research Paper Writing Help Service)<\/p>\n
This recommendation will likely increase demand for early intervention to support patients in<\/p>\n
making lifestyle changes and adopting long-term self-management behaviors.<\/p>\n
Close coordination between healthcare systems, healthcare providers, and community-based<\/p>\n
programs will likely be an essential element of sustainable community-based services.<\/p>\n
Healthcare coverage for preventive services recommended by the USPSTF will likely be an<\/p>\n
important source of funding for community-based programs once barriers to billing and<\/p>\n
reimbursement are addressed.<\/p>\n
Patients with, or at increased risk for, cardiovascular disease may need pre-intervention<\/p>\n
assessments before initiating changes in physical activity, diet, and weight management.<\/p>\n
Patients will need regular, ongoing diabetes care and medication management, which may<\/p>\n
require adjustment as lifestyle changes are adopted.<\/p>\n
Participants may be at increased risk for injuries associated with changes in physical<\/p>\n
activity. This risk can be reduced if walking is emphasized as the primary mode of physical<\/p>\n
activity with gradually increasing activity levels added as tolerated.<\/p>\n
Reduce the proportion of adults with diabetes who have an A1c value above 9 percent \u2014 D\u201103 (https:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/diabetes\/reduce-proportion-adults-<\/p>\n
diabetes-who-have-a1c-value-above-9-percent-d-03)<\/p>\n
Increase the proportion of people with diabetes who get formal diabetes education \u2014 D\u201106 (https:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/diabetes\/increase-proportion-<\/p>\n
people-diabetes-who-get-formal-diabetes-education-d-06)<\/p>\n
https:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/diabetes\/reduce-proportion-adults-diabetes-who-have-a1c-value-above-9-percent-d-03
\nhttps:\/\/health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/diabetes\/increase-proportion-people-diabetes-who-get-formal-diabetes-education-d-06
\n3\/2\/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide<\/p>\n
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The Community Guide<\/p>\n
Page last reviewed: September 03, 2020<\/p>\n
Page last updated: December 22, 2021<\/p>\n
Content Source: The Guide to Community Preventive Services<\/p>\n
Disclaimer:The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task force evidence-based<\/p>\n
recommendations are not mandates for compliance or spending. Instead, they provide<\/p>\n
information and options for decision makers and stakeholders to consider when determining<\/p>\n
which programs, services, and policies best meet the needs, preferences, available resources, and<\/p>\n
constraints of their constituents.<\/p>\n
Sample Citation: Guide to Community Preventive Services. Diabetes Management: Intensive Lifestyle Interventions<\/p>\n
for Patients with Type 2 Diabetes. https:\/\/www.thecommunityguide.org\/findings\/diabetes-<\/p>\n
intensive-lifestyle-interventions-patients-type-2-diabetes. Page last updated: December 22,<\/p>\n
2021. Page accessed: March 2, 2022<\/p>\n
@CPSTF (https:\/\/twitter.com\/cpstf)<\/p>\n
(404) 498-1827<\/p>\n
communityguide@cdc.gov<\/p>\n
Citation and Disclaimer<\/p>\n
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