Development and evaluation of a diabetes prevention and management intervention in elderly hispanics

Elderly Hispanic individuals with prediabetes are at high risk for developing type 2 diabetes. The Diabetes Prevention Program (DPP) clinical efficacy trial demonstrated that weight loss can prevent or slow the progression of type 2 diabetes in high-risk populations regardless of ethnicity, age, or gender. Currently, no DPP translation studies have targeted elderly Hispanic populations to determine the feasibility of a community based DPP intervention. Therefore, it is unknown whether the implementation of a group-based DPP adapted lifestyle intervention in an elderly Hispanic population would decrease risk factors associated with type 2 diabetes. We investigated whether a culturally sensitive diabetes prevention and management intervention derived from the Social Cognitive Theory resulted in changes in body weight, percent body fat, fasting capillary blood glucose, and self-reported physical activity in elderly Hispanics who were either overweight, prediabetic or type 2 diabetic. We hypothesized that weight loss would improve fasting blood glucose levels over time. A total of 15 participants attended an 8-week (1x week) and 4-week non-intervention weight loss intervention adapted from the diabetes prevention program (DPP) curriculum. The outcome variables were measured at week 0 (baseline), 4, 8, and 12 weeks and re-measured at 16weeks after a 4-week non-intervention period. There were significant reductions in weight (p.002) and BMI (p.001) at 12-weeks compared with baseline. Percent body fat did not decrease significantly compared with baseline. Capillary fasting blood glucose levels were not assessed due to lack of data. This study demonstrated that a short-term culturally sensitive diabetes intervention derived from SCT can help elderly Hispanics achieve modest weight loss. Longer interventions are needed to achieve clinically significant weight loss of 5% and to sustain participant motivation. Due to physical limitations, some elderly individuals may not be able to achieve moderate intensity physical activity levels recommended for clinically significant weight loss.