Letting patients make choices for interventions may lower risk of diabetes, USF study finds

With more than 86 million people in the United States walking around with pre-diabetes, a professor along with her colleagues determined they needed to implement a study to help this group of people.

USF College of Public Health’s Dr. Janice Zgibor, Associate Professor in the Department of Epidemiology and Biostatistics, led the study to determine which program would work best.

“Several studies show that diabetes can be prevented by making changes in lifestyle like healthy eating, and increasing the amount of time spent exercising,” Zgibor says. “Individuals living in rural areas are at higher risk than other populations for getting diabetes; therefore, we decided to implement a program that we knew would work in this high-risk group.”

Then participants were split into four groups. The first group would have face-to-face meetings for support on their lifestyle changes, the second would be given an instructional DVD, third an internet-based intervention and the fourth group would be able to choose which of these methods they preferred.

The intervention lasted 12 weeks, with a follow-up after 18 months.

With more than 550 participants involved from eight rural communities, what was the result? The group members who were able to choose the method of support for their lifestyle changes were most successful. Each participant was asked to lose at least five percent of their body weight, as well as decrease at least one cardiovascular disease risk factor following the intervention.

The fourth group, otherwise known as the ‘self-selection’ group, was more than twice as likely to maintain their weight loss after 18 months. Dr. Zgibor found that when people could make their own decisions about what they wanted to do it was the most effective.

“Once diabetes is diagnosed, it is progressive and may lead to complications of the eyes and kidneys,” she says.  “People with diabetes also have a higher chance of having a stroke or heart disease.  The earlier we can diagnose those at highest risk for diabetes, programs that work targeting lifestyle changes can be offered that lower their chance of getting diabetes.”