Lifestyle Intervention to Treat Diabetes in the Marshall Islands

Lifestyle Intervention Trial to Treat Type 2 Diabetes in the Republic of the Marshall Islands

The Republic of the Marshall Islands has the highest prevalence of type 2 diabetes (T2D) in the world. This clinical trial tested whether a community-based, intensive, plant-rich lifestyle intervention with exercise is more effective for treating and managing T2D in the Republic of the Marshall Islands than the standard of diabetes care. The intensive lifestyle intervention consisted of a plant-rich diet and moderate exercise. It centered around a 12-week program of counseling and instruction on healthy eating, exercise, and stress management, as well as hands-on cooking classes and prepared meals. Cardiometabolic outcomes were assessed throughout the intervention and at 24 weeks. The present study is the first randomized clinical trial ever conducted in the Republic of the Marshall Islands and the first lifestyle intervention trial conducted in Micronesia.

Inclusion Criteria:

• Resident of the Republic of Marshall Islands
• Aged 18 - 75 years
• HbA1c ≥ 8.0% or diagnosed with T2D and taking diabetes medication
• Medical clearance to participate from Diabetes Wellness Center (DWC) physicians.

Exclusion Criteria:

• Recent (≤3 months) change in a diabetes-related medication dosage
• A physical or medical condition that would impede participation in the lifestyle intervention (e.g., wheel-chair bound, unstable angina)
• Evidence of significant coronary heart disease
• Previous participation in an intensive lifestyle intervention