Search

Background. It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods. Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results. BMI decreased (P <.001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased (P <.001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to <5.6 mmol/L in 58.1%, 49.3%, and 41.4% of the normal weight, overweight, and obese participants, respectively. Conclusions. To our knowledge, this study is the first outside of Asia to show that LHC is as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese. [ABSTRACT FROM AUTHOR]

We have developed, tested, and successfully implemented an affordable, evidence-based, technologyenabled, data-driven, outcomesoriented, comprehensive lifestyle health coaching (LHC) program. The LHC program has been used primarily to provide services to employees of larger employers (ie, with at least 3000 employees) but has also been implemented in a variety of other settings, including hospitals, cardiac rehabilitation centers, physician practices, and as part of multicenter clinical trials. The program is delivered mainly using the telephone and Internet. Health coaches are guided by a Webbased participant management and tracking system. Lifestyle management interventions are based on several behavior change models and strategies, especially adult learning theory, social learning theory, the stages of change model, single concept learning theory, and motivational interviewing. The program is administered by nonphysician health professionals whose services are integrated with the care provided by participants' physicians. Outcomes data from published studies, including randomized clinical trials and independent third-party conducted research, have documented the clinical effectiveness of this evidence-based approach in terms of modification of multiple risk factors in healthy persons as well as those with certain common chronic diseases. [ABSTRACT FROM AUTHOR]

Almost 1 in 5 U.S. adults with prediabetes have a normal BMI. It is hypothesized that such individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. Normal BMI is an exclusion criterion for many diabetes prevention programs and scarce data are available on the effectiveness of lifestyle intervention in normal weight adults with prediabetes. In this study, we compared the effect of technology-enabled lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight (BMI 18.5-24.9 kg/m2; n = 188), overweight (BMI 25.0-29.9 kg/m2; n = 495) and obese (BMI >30.0 kg/m2; n = 1,214) adults with prediabetes. Subjects were 1,897 consecutive adults with prediabetes (FPG = 100-125 mg/dl and not taking antidiabetic medication) who completed a baseline and follow-up evaluation as part of an LHC program (mean follow-up = 145 days). LHC included 1-on-1 behaviorally-oriented coaching, predominantly via the telephone and Internet, on exercise, nutrition and weight management. BMI decreased significantly (p <0.001) in the overweight (-0.6±1.1 kg/m2) and obese (-1.3±1.8 kg/m2) participants but was unchanged (0.0±1.5 kg/m2) in the normal weight participants. In contrast, weekly aerobic exercise increased (normal weight = 77±167 min/week increase; overweight = 98±191 min/week increase; and obese = 95±146 min/week increase) and FPG decreased (normal weight = -9±9 mg/dl decrease; overweight = -7±9 mg/dl decrease; and obese = -6±10 mg/dl decrease) significantly (p <0.001) in all 3 groups (p <0.05 for magnitude of decrease in FPG in normal weight versus obese participants). FPG was reduced to <100 mg/dl in 62.4%, 51.7% and 43.6% of the normal weight, overweight and obese participants, respectively. These data suggest that LHC is at least as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese. Disclosure: M.K. Salmon: Other Relationship; Self; INTERVENT, International, LLC. B.S. Wright: Stock/Shareholder; Self; INTERVENT International, LLC. T.L. Kridl: Employee; Self; INTERVENT International, LLC. G.C. Faircloth: Stock/Shareholder; Self; INTERVENT International, LLC. R.D. Salmon: Stock/Shareholder; Self; INTERVENT International, LLC. N.F. Gordon: Board Member; Self; PrevCan. Stock/Shareholder; Self; INTERVENT International. [ABSTRACT FROM AUTHOR]

Background . It is hypothesized that normal weight individuals develop diabetes through different pathophysiological mechanisms and that methods of prevention may differ in the absence of overweight/obesity. In this study, we compared the effect of lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese US adults with prediabetes. Methods . Subjects were 1358 individuals who completed baseline and follow-up evaluations as part of an LHC program (follow-up = ~6 months). Participants were stratified, based on baseline body mass index (BMI), into normal weight (n = 129), overweight (n = 345), and obese (n = 884) cohorts. LHC included counseling, predominantly via telehealth, on exercise and nutrition. Results . BMI decreased ( P < .001) in the overweight and obese participants but was unchanged in the normal weight participants. FPG decreased ( P < .001) in all 3 cohorts, and the magnitude of decrease did not differ significantly among cohorts. FPG decreased to <5.6 mmol/L in 58.1%, 49.3%, and 41.4% of the normal weight, overweight, and obese participants, respectively. Conclusions . To our knowledge, this study is the first outside of Asia to show that LHC is as effective in managing FPG in normal weight adults with prediabetes versus those who are overweight/obese., Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: MKS is a non-salaried research associate of a population health management company (INTERVENT International, LLC). NFG, KSR, BSW, and GCF are members of INTERVENT International, LLC. TLK is an employee of INTERVENT International, LLC. MKS and TLK have family members who are members of INTERVENT International, LLC. DC has no potential conflicts of interest relevant to this article., (© 2021 The Author(s).)

We have developed, tested, and successfully implemented an affordable, evidence-based, technology-enabled, data-driven, outcomes-oriented, comprehensive lifestyle health coaching (LHC) program. The LHC program has been used primarily to provide services to employees of larger employers (ie, with at least 3000 employees) but has also been implemented in a variety of other settings, including hospitals, cardiac rehabilitation centers, physician practices, and as part of multicenter clinical trials. The program is delivered mainly using the telephone and Internet. Health coaches are guided by a Web-based participant management and tracking system. Lifestyle management interventions are based on several behavior change models and strategies, especially adult learning theory, social learning theory, the stages of change model, single concept learning theory, and motivational interviewing. The program is administered by nonphysician health professionals whose services are integrated with the care provided by participants' physicians. Outcomes data from published studies, including randomized clinical trials and independent third-party conducted research, have documented the clinical effectiveness of this evidence-based approach in terms of modification of multiple risk factors in healthy persons as well as those with certain common chronic diseases., Competing Interests: Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Gordon, Dr. Salmon, Dr. Wright, Mr. Faircloth and Mr. Reid are members of and Ms. Gordon is an employee of a population health management company (INTERVENT International, LLC).