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A model of translational research for diabetes prevention in low and middle-income countries: The Diabetes Community Lifestyle Improvement Program (D-CLIP) trial

  • Mary Beth Weber
    Correspondence
    Corresponding author at: Emory University, Rollins School of Public Health, 1518 Clifton Road, NE, Room 7040N, Atlanta, GA 30322, United States. Tel.: +1 404 712 1902; fax: +1 404 727 4590.
    Affiliations
    Emory University, Graduate Division of Biological and Biomedical Sciences, Nutrition and Health Sciences Program, 1462 Clifton Road, Suite 314, Atlanta, GA 30322, United States
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  • Harish Ranjani
    Affiliations
    Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, No: 6B, Conran Smith Road, Gopalapuram, Chennai 600086, India
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  • Gaya Celeste Meyers
    Affiliations
    Emory University, Rollins School of Public Health, 1518 Clifton Road, NE, CNR Building, 7th Floor, Atlanta, GA 30322, United States
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  • Viswanathan Mohan
    Affiliations
    Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, No: 6B, Conran Smith Road, Gopalapuram, Chennai 600086, India
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  • K.M. Venkat Narayan
    Affiliations
    Emory University, Rollins School of Public Health, 1518 Clifton Road, NE, CNR Building, 7th Floor, Atlanta, GA 30322, United States
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      Abstract

      Aims

      The Diabetes Community Lifestyle Improvement Program (D-CLIP) aims to implement and evaluate in a controlled, randomized trial the effectiveness, cost-effectiveness, and sustainability of a culturally appropriate, low-cost, and sustainable lifestyle intervention for the prevention of type 2 diabetes mellitus in India.

      Methods

      D-CLIP, a translational research project adapted from the methods and curriculum developed and tested for efficacy in the Diabetes Prevention Program, utilizes innovated methods (a step-wise model of diabetes prevention with lifestyle and metformin added when needed; inclusion of individuals with isolated glucose tolerance, impaired fasting glucose, and both; classes team-taught by professionals and trained community educators) with the goals of increasing diabetes prevention, community acceptability, and long-term dissemination and sustainability of the program. The study outcomes are: diabetes incidence (primary measure of effectiveness), cost-effectiveness, changes in anthropometric measures, plasma lipids, blood pressure, blood glucose, and HbA1c, Program acceptability and sustainability will be assessed using a mixed methods approach.

      Conclusion

      D-CLIP, a low-cost, community-based, research program, addresses the key components of translational research and can be used as a model for prevention of chronic diseases in other low and middle-income country settings (clinicaltrials.gov number, NCT01283308).

      Keywords

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