Effect of Conventional Lifestyle Interventions on Type 2 Diabetes Incidence by Glucose-Defined Prediabetes Phenotype: An Individual-Participant Data Meta-analysis of Randomized Controlled Trials
Thirunavukkarasu Sathish, Kamlesh Khunti, K.M. Venkat Narayan, Viswanathan Mohan, Melanie J. Davies, Thomas Yates, Brian Oldenburg, Kavumpurathu R. Thankappan, Robyn J. Tapp, Ram Bajpai, Ranjit Mohan Anjana, Mary B. Weber, Mohammed K. Ali, Jonathan E. Shaw- Advanced and Specialized Nursing
- Endocrinology, Diabetes and Metabolism
- Internal Medicine
OBJECTIVE
To examine whether the effect of conventional lifestyle interventions on type 2 diabetes incidence differs by glucose-defined prediabetes phenotype.
RESEARCH DESIGN AND METHODS
We searched multiple databases until 1 April 2023 for randomized controlled trials that recruited people with isolated impaired fasting glucose (i-IFG), isolated impaired glucose tolerance (i-IGT), and impaired fasting glucose plus impaired glucose tolerance (IFG+IGT). Individual-participant data were pooled from relevant trials and analyzed through random-effects models with use of the within-trial interactions approach.
RESULTS
Four trials with 2,794 participants (mean age 53.0 years, 60.7% men) were included: 1,240 (44.4%), 796 (28.5%), and 758 (27.1%) had i-IFG, i-IGT, and IFG+IGT, respectively. After a median of 2.5 years, the pooled hazard ratio for diabetes incidence in i-IFG was 0.97 (95% CI 0.66, 1.44), i-IGT 0.65 (0.44, 0.96), and IFG+IGT 0.51 (0.38, 0.68; Pinteraction = 0.01).
CONCLUSIONS
Conventional lifestyle interventions reduced diabetes incidence in people with IGT (with or without IFG) but not in those with i-IFG.