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© 2004 American Public Health Association
RESEARCH AND PRACTICE |
Elizabeth J. Mayer-Davis, Angela M. D’Antonio, Sharon M. Smith, and Richard Schulz are with the Arnold School of Public Health, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC. Gregory Kirkner is an independent consultant in Milton, Mass. Sarah Levin Martin is with the Physical Activity and Health Branch, Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta Ga. Deborah Parra-Medina is with the Department of Health Promotion, Education and Behavior, Arnold School of Public Health, and the Department of Women’s Studies, University of South Carolina, Columbia, SC. Elizabeth J. Mayer-Davis also is with the Center for Research in Nutrition and Health Disparities, University of South Carolina. Richard Schulz also is with the College of Pharmacy, Department of Pharmaceutical and Health Outcomes Sciences, University of South Carolina.
Correspondence: Requests for reprints should be sent to Elizabeth J. Mayer-Davis, PhD, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 (e-mail: mayer{at}gwm.sc.edu).
Objectives. We evaluated lifestyle interventions for diabetic persons who live in rural communities.
Methods. We conducted a 12-month randomized clinical trial (n = 152) of "intensive-lifestyle" (modeled after the NIH Diabetes Prevention Program) and "reimbursable-lifestyle" (intensive-lifestyle intervention delivered in the time allotted for Medicare reimbursement for diabetes education related to nutrition and physical activity) interventions with usual care as a control.
Results. Modest weight loss occurred by 6 months among intensive-lifestyle participants and was greater than the weight loss among usual-care participants (2.6 kg vs 0.4 kg, P<.01). At 12 months, a greater proportion of intensive-lifestyle participants had lost 2 kg or more than usual-care participants (49% vs 25%, P<.05). No differences in weight change were observed between reimbursable-lifestyle and usual-care participants. Glycated hemoglobin was reduced among all groups (P<.05) but was not different between groups.
Conclusions. Improvement in both weight and glycemia was attainable by lifestyle interventions designed for persons who had type 2 diabetes and lived in rural communities.
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