A preliminary randomized trial of a brief dissonance-based type 2 diabetes prevention programme for adults with pre-diabetes

Objective: Conduct a preliminary randomized trial that compared a 6-week type 2 diabetes (T2D) prevention programme to an educational video control for adults with pre-diabetes.

Methods: Adults (N = 62) with pre-diabetes were randomized to the group-delivered Project Health T2D or an educational video control, completing measures at pre-test, post-test and 3-month follow-up.

Results: Participants randomized to the intervention versus control condition showed significantly greater reductions in body fat (d = 0.76, p = 0.002; d = 1.07, p < 0.001), weight (d = 0.59, p = 0.030; 0.65, p = 0.017) and body mass index (BMI = kg/m²; d = 0.60, p = 0.030; 0.67, p = 0.014), significantly greater increases in lean mass (d = 0.80, p = 0.003; 0.93, p = 0.001) at post-test and 3-month follow-up, respectively, and marginally greater reductions in glycated haemoglobin (HbA1c) (d = 0.54, p = 0.056), but not fasting plasma glucose at 3-month follow-up (d = 0.25, p = 0.364). Project Health T2D also produced a marginally greater 75% reduction in future onset of type 2 diabetes compared with educational controls, reducing incidence over the total 5-month observation period from 15% to 4% (odds ratio = 4.52, p = 0.096).

Conclusions: Project Health T2D produced encouraging reductions in body fat, weight and T2D incidence, and increases in lean mass, and is less intensive than other lifestyle modification T2D prevention programme, suggesting that it might be useful to evaluate in a fully powered efficacy trial with a longer follow-up.