Diabetes prevention programs have been developed in the different countries and it is therefore necessary to gain a better understanding of factors affecting the effectiveness of these programs for each society. Accordingly, the purpose of this study was to evaluate the effect of the National Diabetes Control and Prevention Program (NDCPP) on the biochemical and anthropometric indices among a sample of Iranian patients with type 2 diabetes mellitus (T2DM). A total of 384 patients with T2DM from the primary health care system of Tehran and Tabriz cities during January to June 2020, were included in the study. A two-part questionnaire consisting of items related to socio-economic and demographic characteristics was used and biochemical and anthropometric indices were measured at the beginning and the end of the 3-month intervention period. There was a significant difference in fasting blood sugar (FBS), hemoglobin glycosides (HbA1 C), systolic blood pressure (SBP) and weight before and after the NDCPP (P < 0.001). Also, there was significant improvement in carbohydrate (P = 0.015) and protein intake (P = 0.027) after the NDCPP compared to before the study. No significant difference was observed in waist circumference (WC) (P = 0.689), body mass index (P = 0.784), diastolic blood pressure (P = 0.647), and other dietary nutrient intake before and after the NDCPP. Repeated measure ANOVA revealed a significant decrease in FBS (Time effect P = 0.019) and weight (Time effect P = 0.006) after the NDCPP. Also, residing in different cities had a significant effect on FBS (time×city effect P < 0.001), HbA1 C (time×city effect P < 0.001), and SBP (time×city effect P = 0.037) after the NDCPP. The NDCPP resulted in weight loss, improved HbA1 C, and FBS. These findings suggested that NDCPP had a positive effect on controlling T2DM among Iranian population and can be considered as a way to prevent complications of T2DM.
EsteghamatiA, EtemadK, KoohpayehzadehJ, AbbasiM, MeysamieA, NoshadS, AsgariF, MousavizadehM, RafeiA, KhajehE, NeishabouryM. Trends in the prevalence of diabetes and impaired fasting glucose in association with obesity in Iran: 2005–2011. Diabetes Research and Clinical Practice. 2014;103(2):319–27.
4.
JavanbakhtM, MashayekhiA, BaradaranHR, HaghdoostA, AfshinA. Projection of diabetes population size and associated economic burden through in Iran: evidence from micro-simulation Markov model and Bayesian meta-analysis. PloS One. 2015;10(7):e0132505.
5.
WhittemoreR, RosenbergA, GilmoreL, WitheyM, BreaultA. Implementation of a diabetes prevention program in public housing communities. Public Health Nursing. 2014;31(4):317–26.
6.
VlaarEM, van ValkengoedIG, NierkensV, NicolaouM, MiddelkoopBJ, StronksK. Feasibility and effectiveness of a targeted diabetes prevention program for 18 to 60-year-old South Asian migrants: design and methods of the DH! AAN study. BMC Public Health. 2012;12(1):1–3.
7.
AliMK, Echouffo-TcheuguiJB, WilliamsonDF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program?Health Aff. 2012;31(1):67–75.
8.
PalladinoR, VamosEP, ChangKC, KhuntiK, MajeedA, MillettC. Evaluation of the diabetes screening component of a national cardiovascular risk assessment programme in England: a retrospective cohort study. Scientific Reports. 2020;10(1):1–1.
9.
RamachandranA, SnehalathaC, MaryS, MukeshB, BhaskarAD, VijayV. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49(2):289–97.
10.
PimentelGD, Portero-MclellanKC, OliveiraÉP, SpadaAP, OshiiwaM, ZemdegsJC, BarbalhoSM. Long-term nutrition education reducesseveral risk factors for type 2 diabetes mellitus in Brazilians withimpaired glucose tolerance. Nutrition Research. 2010;30(3):186–90.
11.
LiuH, WangL, ZhangS, LengJ, LiN, LiW, TianH, QiL, TuomilehtoJ, YangX, YuZ. 1 year weight losses in the Tianjin Gestational Diabetes Mellitus Prevention Program: a randomised trial. The Lancet Diabetes & Endocrinology. 2016;4:S11.
12.
ObaN, McCaffreyR, ChoonhapranP, ChutugP, RueangramS. Development of a community participation program for diabetes mellitus prevention in a primary care unit, Thailand. Nursing & Health Sciences. 2011;13(3):352–9.
13.
Alirezaei ShahrakiR, SahafR, Abolfathi MomtazY, Khosravi SamaniN. Evaluation of fasting blood sugar and glycated hemoglobin in elderly diabetic patients before and after entering the nationwide program for prevention and control of diabetes in Isfahan. Iranian Journal of Diabetes and Metabolism. 2018;17(5):225–32.
14.
AlaviniaM, GHotbiM, Mahdavi HazavehA, KermanchiJ, Nasli esfahaniAY. Nationwide Program for Prevention and Control of Type II Diabetes: the Ministry of Health: Treatment and Medical Education, Tehran: Sepid Barg; 2012.
15.
KrejcieRV, MorganDW. Determining sample size for research activities. Educational and Psychological Measurement. 1970;30(3):607–10.
16.
PourverdiS, Mohammadi ShahboulaghiF, KashaniniaZ, RezasoltaniP. Effects of self-management program on glycemic control in patients with type 2 diabetes and glycosylated hemoglobin. Journal of Holistic Nursing and Midwifery. 2015;25(4):19–28.
17.
KashfiSM, KhaniJA, BahadoriKR, HatamiM. Evaluation of the effects of educating about nutrition and jogging on the blood sugar of type II diabetic patients of a clinic in Shiraz, Iran. 2009;54-60.
18.
WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia: Melbourne. ISBN 0-9577082-1-1. 2000.
19.
NHLBI Obesity Education Initiative. The practical guide: Identification, evaluation and treatment of overweight and obesity in adults. National Institutes of Health (NIH Publication Number 004084), 2000.
20.
SarkissianN, RahmanianM, AzarM, MayourianH, KhaliliS. Food composition table of Iran. Tehran: National Nutrition and Food Technology Research Institute, 1980.
21.
ZadND, YusofRM, EsmailiH, JamaluddinR, MohseniF. Association of dietary pattern with biochemical blood profiles and bodyweight among adults with Type 2 diabetes mellitus in Tehran, Iran. Journal of Diabetes & Metabolic Disorders. 2015;14(1):28.
22.
RawalLB, TappRJ, WilliamsED, ChanC, YasinS, OldenburgB. Prevention of type 2 diabetes and its complications in developing countries: a review. International Journal of Behavioral Medicine. 2012;19(2):121–33.
23.
AlbertiKGMM, ZimmetP, ShawJ. International Diabetes Federation: a consensus on type 2 diabetes prevention. Diabet Med. 2007;24:451–63.
24.
LindstromJ, LouherantaA, MannelinM, RastasM, SalminenV, ErikssonJ, et al. The Finnish diabetes prevention study (DPS), lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26:3230–6.
25.
KnowlerWC, Barrett-ConnorE, FowlerSE, HammanRF, LachinJM, WalkerEA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.
26.
GilliesCL, AbramsKR, LambertPC, CooperNJ, SuttonAJ, HsuRT, et al. Pharmacological and lifestyle interventions to prevent or delay type 2 diabetes in people with impaired glucose tolerance: systematic review and meta-analysis. BMJ. 2007;334:299–302.
27.
SambB, DesaiN, NishtarS, BekedamH, WrightA, HsuJ, et al. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. Lancet. 2010;376:1785–97.
28.
WaeberB, de la SierraA, RuilopeLM. The ADVANCE trial: clarifying the role of perindopril/indapamide fixed-dose combination in the reduction of cardiovascular and renal events in patients with diabetes mellitus. Am J Cardiovasc Drug. 2009;9:283–91.
29.
RautioN, JokelainenJ, OksaH, SaaristoT, PeltonenM, NiskanenL, PuolijokiH, VanhalaM, UusitupaM, Keinänen-KiukaanniemiS, FIN-D2D Study Group.. Socioeconomic position and effectiveness of lifestyle intervention in prevention of type 2 diabetes: one-year follow-up of the FIN-D2D project. Scandinavian Journal of Public Health. 2011;39(6):561–70.
30.
AbsetzP, ValveR, OldenburgB, HeinonenH, NissinenA, FogelholmM, IlvesmäkiV, TaljaM, UutelaA. Type 2 diabetes prevention in the “real world”: one-year results of the GOAL Implementation Trial. Diabetes Care. 2007;30(10):2465–70.
31.
HuZ, QinL, XuH. One-year results of a synthetic intervention model for the primary prevention of T2D among elderly individuals with prediabetes in rural China. International Journal of Environmental Research and Public Health. 2017;14(4):417.
32.
LimayeT, KumaranK, JoglekarC, BhatD, KulkarniR, NanivadekarA, YajnikC. Efficacy of a virtual assistance-based lifestyle intervention in reducing risk factors for Type 2 diabetes in young employees in the information technology industry in India: LIMIT, a randomized controlled trial. Diabetic Medicine. 2017;34(4):563–8.
33.
DunkleyAJ, BodicoatDH, GreavesCJ, RussellC, YatesT, DaviesMJ, KhuntiK. Diabetes prevention in the real world: effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations: a systematic review and meta-analysis. Diabetes care. 2014;37(4):922–33.
34.
RuggieroL, OrosS, ChoiYK. Community-based translation of the diabetes prevention program’s lifestyle intervention in an underserved Latino population. The Diabetes Educator. 2011;37(4):564–72.
35.
MakrilakisK, LiatisS, GrammatikouS, PerreaD, KatsilambrosN. Implementation and effectiveness of the first community lifestyle intervention programme to prevent Type 2 diabetes in Greece. The DE-PLAN study. Diabetic Medicine. 2010;27(4):459–65.
36.
SavasLA, GradyK, CotterillS, SummersL, BoadenR, GibsonJM. Prioritising prevention: implementation of IGT Care Call, a telephone-based service for people at risk of developing type 2 diabetes. Primary Care Diabetes. 2015;9(1):3–8.
37.
KimHS, SongMS. Technological intervention for obese patients with type 2 diabetes. Applied Nursing Research. 2008;21(2):84–9.
38.
OckeneIS, TellezTL, RosalMC, ReedGW, MordesJ, MerriamPA, OlendzkiBC, HandelmanG, NicolosiR, MaY. Outcomes of a Latino community-based intervention for the prevention of diabetes: the Lawrence Latino Diabetes Prevention Project. American Journal of Public Health. 2012;102(2):336–42.
39.
JiangL, MansonSM, BealsJ, HendersonWG, HuangH, ActonKJ, RoubideauxY, Special Diabetes Program for Indians Diabetes Prevention Demonstration Project. Translating the diabetes prevention program into American Indian and Alaska native communities: results from the special diabetes program for Indians diabetes prevention demonstration project. Diabetes care. 2013;36(7):2027–34.
40.
TranVD, JamesAP, LeeAH, JanceyJ, HowatPA, Thi Phuong MaiL. Effectiveness of a community-based physical activity and nutrition behavior intervention on features of the metabolic syndrome: a cluster-randomized controlled trial. Metabolic Syndrome and Related Disorders. 2017;15(2):63–71.
41.
Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet. 2009;374(9702):1677–86.
42.
SaaristoT, MoilanenL, Korpi-HyövältiE, VanhalaM, SaltevoJ, NiskanenL, JokelainenJ, PeltonenM, OksaH, TuomilehtoJ, UusitupaM. Lifestyle intervention for prevention of type 2 diabetes in primary health care: one-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D). Diabetes Care. 2010;33(10):2146–51.
43.
ZhangH, XuW, DahlAK, XuZ, WangHX, QiX. Relation of socio-economic status to impaired fasting glucose and Type 2 diabetes: findings based on a large population-based cross-sectional study in Tianjin, China. Diabetic Medicine. 2013;30(5):e157–62.
44.
TaoX, LiJ, ZhuX, ZhaoB, SunJ, JiL, HuD, PanC, HuangY, JiangS, FengQ. Association between socioeconomic status and metabolic control and diabetes complications: a cross-sectional nationwide study in Chinese adults with type 2 diabetes mellitus. Cardiovascular Diabetology. 2016;15(1):1–0.
45.
ChaufanC, DavisM, ConstantinoS. The twin epidemics of poverty and diabetes: understanding diabetes disparities in a low-income Latino and immigrant neighborhood. Journal of Community Health. 2011;36(6):1032–43.
46.
BrunnerE, MarmotMG. Social organization, stress, and health. In: Marmot MG, Wilkinson RG, editors. Social determinants of health. Oxford: Oxford University Press; 1999. pp. 17–43.
47.
Dinca-PanaitescuM, Dinca-PanaitescuS, RaphaelD, BryantT, PilkingtonB, DaiskiI. The dynamics of the relationship between diabetes incidence and low income: longitudinal results from Canada’s National Population Health Survey. Maturitas. 2012;72(3):229–35.
48.
VijayaraghavanM, JacobsEA, SeligmanH, FernandezA. The association between housing instability, food insecurity, and diabetes self-efficacy in low-income adults. Journal of Health Care for the Poor and Underserved. 2011;22(4):1279–91.
