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| Name | Class |
|---|---|
| Robert C. Atkins Foundation | OTHER |
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Heart disease is a leading cause of death in people in the United States. It is a major problem for those with diabetes. Conditions called the metabolic syndrome and pre-diabetes increase risk for diabetes and heart disease. The metabolic syndrome is a group of disorders that occur at the same time. Overall, one in four American adults has the metabolic syndrome. It is more common in people over the age of 40. The metabolic syndrome includes: 1) large waist size, 2) high triglycerides, 3) low HDL cholesterol, 4) high blood pressure and 5) high fasting blood sugar. People with the metabolic syndrome have at least three of these five risk factors. Pre-diabetes is considered to be present in those with high fasting blood sugar levels below the diabetes range.
Research has shown that type 2 diabetes and the metabolic syndrome may be prevented or delayed by making lifestyle changes. It is not known what will most help people continue these healthy changes over time. The purpose of this study is to look at ways to help people continue the healthy lifestyle changes they have made while taking part in a diabetes prevention program called Group Lifestyle Balance (GLB).
Objective: To determine the effectiveness of the Group Lifestyle Balance (GLB) program with an added maintenance component focusing on carbohydrate reduction and hunger management when compared to the GLB program with traditional maintenance.
Research Design and Methods: The original Diabetes Prevention Program intervention was modified from a 16 session individual intervention to a 12 session group-based program called Group Lifestyle Balance (GLB). The Diabetes Prevention Support Center (DPSC) has been created to oversee the implementation of diabetes prevention and CVD risk reduction in various community settings. GLB is a 12-session group based program that focuses on a low fat diet, weight loss and physical activity. This evidence-based intervention is directed at those with pre-diabetes and/or the metabolic syndrome. A monthly maintenance component will be added which provides support in assisting individuals who have completed the 12-session course in the maintenance of healthy lifestyle changes.
The efficacy (in terms of weight reduction) of an added maintenance component focusing on carbohydrate reduction and hunger management will be compared to traditional maintenance. Participants will be randomly assigned to either GLB traditional maintenance (GLB-TM) or GLB and carbohydrate reduced maintenance (GLB-CRM). There will be two groups of approximately 15 subjects in each intervention assignment, for a total of approximately 30 subjects per intervention group and approximately 60 subjects taking part overall. Efficacy in both groups will be assessed by pre and post-intervention measures of diet (weight loss) and physical activity (the keystones of the intervention), as well as the achievement of the two goals: a 7% weight loss by the end of 6 months and 150 minutes of physical activity per week. Secondary outcomes to be evaluated include the reduction of global CVD risk, as assessed by the Framingham Score, the presence of metabolic syndrome (NCEP ATP III), and a fall in blood sugar. Repeat measures will be obtained at six months and one year for further evaluation and comparison.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GLB Traditional Maintenance (TM) | Active Comparator | Group Lifestyle Balance (GLB) program Traditional Maintenance: After completion of the GLB 12 core sessions, participants who are randomly assigned to GLB program Traditional Maintenance (TM) will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. |
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| GLB-Carb-focused Maintenance (CF) | Active Comparator | Group Lifestyle Balance (GLB) program Carb-focused Maintenance: After completion of the GLB 12 core sessions, participants randomly assigned to GLB Carb-focused Maintenance (CF) will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information regarding healthy carbohydrate intake and hunger management. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| GLB Traditional Maintenance (TM) | Behavioral | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Weight | Weight was measured twice without shoes with the average computed; participants were asked to remove their shoes at each measure. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Total Cholesterol | Total cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in HDL Cholesterol |
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Inclusion Criteria:
Non-diabetic patients with metabolic syndrome AND/OR pre-diabetes are eligible for this project based on the following criteria:
Metabolic Syndrome:
Patients with BMI ≥ 25 kg/m2, with at least 3 of the following risk factors for metabolic syndrome:
Pre-diabetes:
Patients with a BMI ≥25 kg/m2 and pre-diabetes (fasting glucose ≥100 mg/dL and <126mg/dL)
All measures should have been taken within one year of enrollment into the study. A permission for physical activity form must be signed by the participant's physician in order to take part in the study.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Trevor J Orchard, MD | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Diabetes Prevention Support Center | Pittsburgh | Pennsylvania | 15213 | United States |
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| Label | URL |
|---|---|
| Diabetes Prevention Support Center of the University of Pittsburgh | View source |
| Long-term Strategies for Diabetes Prevention: Evaluation of the Group Lifestyle Balance Post-Core Sessions Focusing on Carbohydrate and Hunger Management | View source |
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The project was implemented in two settings: the first within an urban University campus and the second at a suburban YMCA. Recruitment commenced in May 2009 and was completed in July 2009.
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| ID | Title | Description |
|---|---|---|
| FG000 | GLB Traditional Maintenance (TM) | Group Lifestyle Balance (GLB) program Traditional Maintenance. Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. GLB Traditional Maintenance: Group Lifestyle Balance (GLB)-Carb-focused Maintenance: Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
| FG001 | GLB-Carb-focused Maintenance (CF) | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information regarding healthy carbohydrate intake and hunger management. GLB-Carb-focused Maintenance: After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | GLB Traditional Maintenance (TM) | Group Lifestyle Balance (GLB) program Traditional Maintenance. Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. GLB Traditional Maintenance: Group Lifestyle Balance (GLB)-Carb-focused Maintenance: Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in Weight | Weight was measured twice without shoes with the average computed; participants were asked to remove their shoes at each measure. | Intention to treat analyses were performed; for those with missing weights at the post-intervention, 8 and 12 month visits, the last documented observation was carried forward. This information was available from the session data, where weight was collected weekly. | Posted | Mean | Standard Deviation | pounds | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
|
Approximately 1 year.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | GLB Traditional Maintenance (TM) | Group Lifestyle Balance (GLB) program Traditional Maintenance. Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. GLB Traditional Maintenance: Group Lifestyle Balance (GLB)-Carb-focused Maintenance: Participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
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The sample size was small and included primarily white individuals, so these results may not be generalizable to other groups. The CPC was not carbohydrate restricted and may not be directly comparable to studies that focus on carbohydrate reduction.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Trevor J Orchard | University of Pittsburgh | 412-383-1032 | tjo@pitt.edu |
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| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| GLB-Carb-focused Maintenance (CF) | Behavioral | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
|
High-density lipoprotein (HDL) cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. |
| Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in LDL Cholesterol | Low-density lipoprotein (LDL) cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Triglycerides | Triglycerides were measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Fasting Glucose | Fasting plasma glucose was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Glycosylated Hemoglobin A1c (HbA1c) | Collected via venous blood draw, the HbA1c level reflects glucose concentration over the previous period (approximately 8-12 weeks, depending on the individual) and provides an indication of long-term glycemic control. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Systolic Blood Pressure | Blood pressure was measured in a sitting position in the right arm after resting for five minutes. First appearance and last heard (phase V) Korotkoff's sounds were used to define the pressure readings; the measures were repeated twice with a thirty second wait between each reading. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Diastolic Blood Pressure | Blood pressure was measured in a sitting position in the right arm after resting for five minutes. First appearance and last heard (phase V) Korotkoff's sounds were used to define the pressure readings; the measures were repeated twice with a thirty second wait between each reading. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| Change in Waist Circumference | Waist circumference was measured at the midpoint between the lower rib margin and the iliac crest; the measurement was repeated twice and the average computed. | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
| BG001 | GLB-Carb-focused Maintenance (CF) | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information regarding healthy carbohydrate intake and hunger management. GLB-Carb-focused Maintenance: After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| OG001 | GLB-Carb-focused Maintenance (CF) | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information regarding healthy carbohydrate intake and hunger management. GLB-Carb-focused Maintenance: After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. |
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| Secondary | Change in Total Cholesterol | Total cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Participants with medication changes relevant to the outcome were excluded. | Posted | Mean | Standard Deviation | mg/dl | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in HDL Cholesterol | High-density lipoprotein (HDL) cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Participants with medication changes relevant to the outcome were excluded. | Posted | Mean | Standard Deviation | mg/dl | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in LDL Cholesterol | Low-density lipoprotein (LDL) cholesterol was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Participants with medication changes relevant to the outcome were excluded. | Posted | Mean | Standard Deviation | mg/dl | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Triglycerides | Triglycerides were measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | mg/dl | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Fasting Glucose | Fasting plasma glucose was measured after at least an eight-hour fast using the Cholestech LDX System by a certified research assistant. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | mg/dl | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Glycosylated Hemoglobin A1c (HbA1c) | Collected via venous blood draw, the HbA1c level reflects glucose concentration over the previous period (approximately 8-12 weeks, depending on the individual) and provides an indication of long-term glycemic control. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | percentage of glycosylated hemoglobin | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Systolic Blood Pressure | Blood pressure was measured in a sitting position in the right arm after resting for five minutes. First appearance and last heard (phase V) Korotkoff's sounds were used to define the pressure readings; the measures were repeated twice with a thirty second wait between each reading. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | mmHg | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Diastolic Blood Pressure | Blood pressure was measured in a sitting position in the right arm after resting for five minutes. First appearance and last heard (phase V) Korotkoff's sounds were used to define the pressure readings; the measures were repeated twice with a thirty second wait between each reading. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | mmHg | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| Secondary | Change in Waist Circumference | Waist circumference was measured at the midpoint between the lower rib margin and the iliac crest; the measurement was repeated twice and the average computed. | Participants with relevant medication changes were excluded. | Posted | Mean | Standard Deviation | inches | Measured at 8 months post intervention and 4 months post-randomization to maintenance group |
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| 0 |
| 31 |
| 0 |
| 31 |
| EG001 | GLB-Carb-focused Maintenance (CF) | After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information regarding healthy carbohydrate intake and hunger management. GLB-Carb-focused Maintenance: After completion of the GLB 12 core sessions, participants will be randomly assigned to either Group Lifestyle Balance (GLB) program traditional maintenance or GLB Carb-focused maintenance. GLB-CF participants will attend monthly maintenance sessions to assist them in maintaining the healthy lifestyle they have adopted during the 12 Core sessions. In addition, they will receive information on healthy carbohydrate intake and hunger management. | 0 | 29 | 0 | 29 |
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