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418 community-dwelling nondiabetic persons agedx = 46 years; follow-up 2 yrs; in progress. Outcome: diabetes Diabetes Prevention Study (DPS) Finland: 5 centers,

522 men and women aged x = 55 years, BMI = 31, WHO IGT X 2; follow-up 3.2 years. Outcome: diabetes by WHO criteria Diabetes Prevention Program (DPP) 27 US centers, 3234 men

Diet (N = 15): Very low calorie (925 Kcal/d) increasing to 1500 Kcal/d by week 22. Diet + aerobic exercise (N = 14): Step aerobics 40 min/week. Diet + resistance exercise (N = 16): 40 min/week on large muscle groups Lifestyle (N = 253): lower fat, saturated fat, increased physical activity. Control (N = 236): assessment only

Intervention (N = 209) diet, exercise, stress management yearly. Standard (N = 209) no intervention

Intervention (N = 265): diet, exercise, weight loss in 7 sessions in year 1, then 4 times per year. Control (N = 257): annual information

Intensive lifestyle

(N = 1079): 16 session curriculum on diet, activity,

Nonsignificant decrease in F and AUC glucose. No difference between groups. Significantly lower F and AUC insulin to week 44 in all groups, so insulin sensitivity likely increased. F insulin rose in persons followed from 44-96 weeks with only slight weight regain. Significant decreases in diastolic BP were equal across groups

Lifestyle: —3.0 kg at 18 months, —0.1 kg at 54 months; F glucose + 1.6 mg/dl (0.09 mmol/L); lower LDL-C, chol., and SBP; lower waist/hip ratio, TGs, and DBP at 6 months, did not persist at 18 or 54 months. Control: gained +2.4 kg at 54 months; F glucose +3.3 mg/dl (0.18 mmol/L)

RR = 1.0 (0.38-2.80) for diabetes progression (3.5% in each group); no changes in risk factors for insulin resistance at two years between groups

All groups treated; no control: no additive effect of diet with either type of exercise, perhaps due to use of very low calorie diets for rapid weight loss. No important effect on glucose levels; no data presented on percentage with IGT. 20% dropout at 44 weeks; 51% at 96 weeks. Allocation not masked

5% dropouts at 54 months, dropouts similar except for higher BMI at entry (26.3 versus 25). Masking of allocation not noted. No OGTT conducted; diabetes rates not reported

Low-intensity intervention with 2 meetings per year, monthly phone calls, newsletters. Details of randomization and blinding not given to tn <

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