PT - JOURNAL ARTICLE AU - James A Dunbar AU - Andrea L Hernan AU - Edward D Janus AU - Erkki Vartiainen AU - Tiina Laatikainen AU - Vincent L Versace AU - John Reynolds AU - James D Best AU - Timothy C Skinner AU - Sharleen L O'Reilly AU - Kevin P Mc Namara AU - Elizabeth Stewart AU - Michael Coates AU - Catherine M Bennett AU - Rob Carter TI - Challenges of diabetes prevention in the real world: results and lessons from the Melbourne Diabetes Prevention Study AID - 10.1136/bmjdrc-2015-000131 DP - 2015 Oct 01 TA - BMJ Open Diabetes Research & Care PG - e000131 VI - 3 IP - 1 4099 - http://drc.bmj.com/content/3/1/e000131.short 4100 - http://drc.bmj.com/content/3/1/e000131.full SO - BMJ Open Diab Res Care2015 Oct 01; 3 AB - Objective To assess effectiveness and implementability of the public health programme Life! Taking action on diabetes in Australian people at risk of developing type 2 diabetes.Research design and methods Melbourne Diabetes Prevention Study (MDPS) was a unique study assessing effectiveness of Life! that used a randomized controlled trial design. Intervention participants with AUSDRISK score ≥15 received 1 individual and 5 structured 90 min group sessions. Controls received usual care. Outcome measures were obtained for all participants at baseline and 12 months and, additionally, for intervention participants at 3 months. Per protocol set (PPS) and intention to treat (ITT) analyses were performed.Results PPS analyses were considered more informative from our study. In PPS analyses, intervention participants significantly improved in weight (−1.13 kg, p=0.016), waist circumference (−1.35 cm, p=0.044), systolic (−5.2 mm Hg, p=0.028) and diastolic blood pressure (−3.2 mm Hg, p=0.030) compared with controls. Based on observed weight change, estimated risk of developing diabetes reduced by 9.6% in the intervention and increased by 3.3% in control participants. Absolute 5-year cardiovascular disease (CVD) risk reduced significantly for intervention participants by 0.97 percentage points from 9.35% (10.4% relative risk reduction). In control participants, the risk increased by 0.11 percentage points (1.3% relative risk increase). The net effect for the change in CVD risk was −1.08 percentage points of absolute risk (p=0.013).Conclusions MDPS effectively reduced the risk of diabetes and CVD, but the intervention effect on weight and waist reduction was modest due to the challenges in recruiting high-risk individuals and the abbreviated intervention.