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Open Access Highly Accessed Study protocol

The Sydney Diabetes Prevention Program: A community-based translational study

Stephen Colagiuri1*, Philip Vita2, Magnolia Cardona-Morrell2, Maria Fiatarone Singh3, Louise Farrell2, Andrew Milat4, Marion Haas5 and Adrian Bauman6

Author Affiliations

1 Boden Institute of Obesity, Nutrition and Exercise, University of Sydney, NSW, Australia

2 Sydney South West Area Health Service, NSW, Australia

3 Exercise, Health and Performance Faculty Research Group, Faculty of Health Sciences, and Sydney Medical School, University of Sydney, NSW, Australia

4 NSW Department of Health, NSW, Australia

5 University of Technology, NSW, Australia

6 School of Public Health, University of Sydney, NSW, Australia

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BMC Public Health 2010, 10:328  doi:10.1186/1471-2458-10-328

Published: 10 June 2010

Abstract

Background

Type 2 diabetes is a major public health problem in Australia with prevalence increasing in parallel with increasing obesity. Prevention is an essential component of strategies to reduce the diabetes burden. There is strong and consistent evidence from randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet, increases physical activity and achieves weight loss in at risk people. The current challenge is to translate this evidence into routine community settings, determine feasible and effective ways of delivering the intervention and providing on-going support to sustain successful behavioural changes.

Methods/Design

The Sydney Diabetes Prevention Program (SDPP) is a translational study which will be conducted in 1,550 participants aged 50-65 years (including 100 indigenous people aged 18 years and older) at high risk of future development of diabetes. Participants will be identified through a screening and recruitment program delivered through primary care and will be offered a community-based lifestyle modification intervention. The intervention comprises an initial individual session and three group sessions based on behaviour change principles and focuses on five goals: 5% weight loss, 210 min/week physical activity (aerobic and strength training exercise), limit dietary fat and saturated fat to less than 30% and 10% of energy intake respectively, and at least 15 g/1000 kcal dietary fibre. This is followed by 3-monthly contact with participants to review progress and offer ongoing lifestyle advice for 12 months. The effectiveness and costs of the program on diabetes-related risk factors will be evaluated. Main outcomes include changes in weight, physical activity, and dietary changes (fat, saturated fat and fibre intake). Secondary outcomes include changes in waist circumference, fasting plasma glucose, blood pressure, lipids, quality of life, psychological well being, medication use and health service utilization.

Discussion

This translational study will ascertain the reach, feasibility, effectiveness and cost-effectiveness of a lifestyle modification program delivered in a community setting through primary health care. If demonstrated to be effective, it will result in recommendations for policy change and practical methods for a wider community program for preventing or delaying the onset of type 2 diabetes in high risk people.