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Outcome of intensive integrated intervention in participants with impaired glucose regulation in China
Lu Y-H, Lu J-M, Wang S-Y, Li C-L, Zheng R-P, Tian H, Wang X-L
Advances in Therapy 2011 Jun;28(6):511-519
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

INTRODUCTION: This study investigated the outcomes and identified influencing factors of intensive integrated intervention over 2 years in Chinese patients with impaired glucose regulation (IGR). METHODS: Adults in Beijing, China, were screened for IGR using the 75 g oral glucose tolerance test. Participants with IGR received lifestyle and health education; those who still had IGR after 1 year were randomly assigned to either a routine care group or to an intensive integrated intervention group. RESULTS: Of 2344 adults screened, 463 had IGR. Of these, 210 adults had IGR after 1 year and were therefore recruited and randomized to an intensive integrated intervention group (n = 106) or a control group (n = 104). The percentage of patients who reached the set targets of plasma glucose, blood pressure, body mass index, or triglycerides was significantly higher in the intensive integrated intervention group. None of the patients within the intensive integrated intervention group progressed to diabetes, whereas eight (9.3%) cases of the control group developed type 2 diabetes mellitus (T2DM). Logistic regression analysis showed that both an increase in waist circumference and systolic blood pressure (SBP) were positively correlated with the development of T2DM, whereas improvement in islet beta cell function was negatively correlated with the development of T2DM. CONCLUSIONS: Intensive integrated intervention may significantly decrease the conversion rate of IGR to T2DM, and increase the conversion ratio to normal glucose tolerance. The increase of waist circumference or SBP and the deterioration of islet beta cell function may be important risk factors for progression from prediabetes to diabetes.

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