A pragmatic lifestyle modification programme reduces the incidence of predictors of cardio-metabolic disease and dysglycaemia in a young healthy urban South Asian population: a randomised controlled trial

• DOI: 10.1186/s12916-017-0905-6
• Publication Date: 2017-08-01T13:53:35Z
• Authors: Mahen Wijesuriya; Nikolaos Fountoul...; Nicola Guess; Sarath Banneheka; Laksha Vasantharajah; Martin Gulliford; Giancarlo Viberti; Luigi Gnudi; Janaka Karalliedde
• Keywords: Impaired fasting glucose; Clinical endpoint; Post-hoc analysis; Rate ratio; Cumulative incidence

There is an increasing incidence of type 2 diabetes mellitus (T2DM) in young urban South-Asians. We tested the effect a pragmatic trimonthly lifestyle modification (LSM) programme (P-LSM) versus less-intensive 12-monthly control LSM (C-LSM) intervention on primary composite endpoint predictors cardio-metabolic disease (new onset T2DM, hypertension, impaired glucose tolerance (IGT), fasting glycaemia (IFG) and markers cardio-renal disease) participants aged 5–40 years with risk factors for T2DM. This was randomised controlled trial performed at National Diabetes Centre, Sri-Lanka. individually 4672 whom 3539 (mean age 22.5 (range 6–40 years, 48% males) received either (P-LSM n = 1726) or (C-LSM 1813) peer educator advice aimed reducing weight, improving diet, psychological stress physical activity. During median follow-up 3 cumulative 479 P-LSM (74 per 1000 person years) vs. 561 C-LSM (96 years), incident rate ratio (IRR) 0.89 (95% CI 0.83–0.96, P 0.02). In post hoc analyses, new dysglycaemia (T2DM, IFG IGT), major contributor to significantly reduced by (IRR 0.9, 95% 0.83–0.97, 0.01). A significant impact noted 1725 850, 875) below 18; 140 (48 174 (55.4 IRR 0.83 0.73–0.94, 0.004). at-risk South-Asian population, reduces disease. Our results highlight importance early subjects. World Health Organization international clinical registry platform ( SLCTR/2008/003 ). Registration Date: March 28, 2008. Retrospectively registered.