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Effects of a digital diabetes prevention program on cardiovascular risk among individuals with prediabetes

Published:January 23, 2023DOI:https://doi.org/10.1016/j.pcd.2023.01.007

      Highlights

      • The 10-year CVD risk was reduced by 0.96% with a d‐DPP at 4 months.
      • The proportion of people with cardiometabolic risk factors was reduced in a d‐DPP.
      • Targeting peoples with prediabetes at intermediate or high ASCVD risk at baseline.

      Abstract

      Objective

      To examine changes in cardiovascular disease (CVD) risk outcomes of overweight/obese adults with prediabetes.

      Methods

      Using data from a randomized control trial of digital diabetes prevention program (d‐DPP) with 599 participants. We applied the atherosclerotic CVD (ASCVD) risk calculator to predict 10-year CVD risk for d‐DPP and small education (comparison) groups. Between-group risk changes at 4 and 12 months were compared using a repeated measures linear mixed-effect model. We examined within-group differences in proportion of participants over time for specific CVD risk factors using generalized estimating equations.

      Results

      We found no differences between baseline 10-year ASCVD risk. Relative to the comparison group, the d‐DPP group experienced greater reductions in predicted 10-year ASCVD risk at each follow-up visit and a significant group difference at 4 months (−0.96%; 95% confidence interval: −1.58%, −0.34%) (but not at 12 months). Additionally, we observed that the d‐DPP group experienced a decreased proportion of individuals with hyperlipidemia (18% and 16% from baseline to 4 and 12 months), high-risk total cholesterol (8% from baseline to 12 months), and being insufficiently active (26% and 22% from baseline to 4 and 12 months at follow-up time points.

      Conclusions

      Our findings suggest that a digitally adapted DPP may promote the prevention of cardiometabolic disease among overweight/obese individuals with prediabetes. However, given the lack of maintenance of effect on ASCVD risk at 12 months, there may also be a need for additional interventions to sustain the effect detected at 4 months.

      Keywords

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