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Posted: April 14th, 2022
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3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 1/8
Systematic Review
Topic Diabetes, Obesity
Recommended (suf�cient evidence)
Audience Adults, Older Adults
Setting Clinical/Health Systems, Community
Strategy Counseling, Health Education
Diabetes Management: Intensive Lifestyle Interventions for Patients with Type 2 Diabetes
October 2016: 2024 – Do my homework – Help write my assignment online
This webpage summarizes information available in the CPSTF Findings and Rationale Statement, located under the Snapshot tab.
The Community Guide (https://www.thecommunityguide.org)
Homework help – Summary of CPSTF Finding
The Community Preventive Services Task Force (CPSTF) recommends intensive lifestyle interventions for
patients with type 2 diabetes to improve glycemic control and reduce risk factors for cardiovascular
disease.
Intervention
CPSTF Finding and Rationale Statement
Intensive lifestyle interventions provide ongoing counseling, coaching, or individualized guidance to
patients with type 2 diabetes to help them change their diet, level of physical activity, or both. Patients
must interact with program staff multiple times for a period of six months or longer.
Dietary components may include tailored advice, and physical activity components may include
structured and personalized guidance or supervised exercise training. Programs may have weight loss
goals or include additional components related to weight loss or maintenance.
The largest and longest trial to date provided intensive individual and group counseling and extended
interpersonal support for dietary changes, regular physical activity, and weight management.
https://www.thecommunityguide.org/topic/diabetes
https://www.thecommunityguide.org/topic/obesity
https://www.thecommunityguide.org/
https://www.thecommunityguide.org/task-force/about-community-preventive-services-task-force
https://www.thecommunityguide.org/task-force/understanding-task-force-findings-and-recommendations
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Read the full CPSTF Finding and Rationale Statement [PDF – 793 KB] for details including implementation
issues, possible added benefits, potential harms, and evidence gaps.
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About The Systematic Review
Homework help – Summary of Results
Intensive Lifestyle Interventions Reduce Cardiovascular Risk Among People with Type 2 Diabetes
Intensive Lifestyle Interventions for Patients with Type 2 Diabetes
Mental Health: Targeted School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and
Anxiety Symptoms
Violence Prevention: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence
and Sexual Violence Among Youth
Diabetes Prevention: Interventions Engaging Community Health Workers
The CPSTF uses recently published systematic reviews to conduct accelerated assessments of
interventions that could provide program planners and decision-makers with additional, effective
options. The following published review was selected and evaluated by a team of specialists in
systematic review methods, and in research, practice, and policy related to diabetes management
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.
The systematic review and meta-analysis included 17 studies (Huang et al., 2016: 2024 – Do my homework – Help write my assignment online; search period
through July 15, 2014: 2024 – Essay Writing Service | Write My Essay For Me Without Delay). The CPSTF finding is based on results from a subset of 7 studies that evaluated
intensive physical activity programs (5 studies) and intensive dietary programs (3 studies) in addition
to expert input from team members and the CPSTF. The largest and longest study (Look AHEAD trial)
evaluated both intensive dietary and physical activity programs.
https://www.thecommunityguide.org/sites/default/files/assets/Diabetes-Lifestyle-Interventions.pdf
https://www.thecommunityguide.org/content/intensive-lifestyle-interventions-reduce-cardiovascular-risk-among-people-type-2-diabetes
https://www.thecommunityguide.org/resources/one-pager-intensive-lifestyle-interventions-patients-type-2-diabetes
https://www.thecommunityguide.org/findings/mental-health-targeted-school-based-cognitive-behavioral-therapy-programs-reduce-depression-anxiety-symptoms
https://www.thecommunityguide.org/findings/violence-prevention-primary-prevention-interventions-reduce-perpetration-intimate-partner-violence-sexual-violence-among-youth
https://www.thecommunityguide.org/findings/diabetes-prevention-interventions-engaging-community-health-workers
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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Homework help – Summary of Economic Evidence
Huang et al. did not consider evidence or information on the economic benefits of these interventions.
An economic evaluation of the Look AHEAD trial reported lower health-care costs over 10 years.
Applicability
Based on evidence from the review, the CPSTF finding is applicable to interventions offered to adults
with type 2 diabetes through healthcare settings in the United States.
Evidence Gaps
Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF –
793 KB].
The systematic review included 7 studies. The largest and longest study (Look AHEAD trial) evaluated
both intensive dietary and physical activity programs.
Dietary Programs (3 studies)
Intensive dietary programs led to favorable changes in reported outcomes.
Body Mass Index: non-significant decrease
Blood glucose (A1c): significant decrease
Systolic blood pressure: significant decrease
Diastolic blood pressure: significant decrease
LDL cholesterol: non-significant decrease
HDL cholesterol: significant increase
Physical Activity Programs (5 studies)
Intensive physical activity programs led to favorable changes in reported outcomes.
Body Mass Index: non-significant decrease
Blood glucose (A1c): significant decrease
Systolic blood pressure: non-significant decrease
Diastolic blood pressure: significant decrease
LDL cholesterol: non-significant decrease
HDL cholesterol: non-significant increase
https://www.thecommunityguide.org/sites/default/files/assets/Diabetes-Lifestyle-Interventions.pdf
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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Study Characteristics
Analytic Framework
No content is available for this section.
Homework help – Summary Evidence Table
A summary evidence table for this Community Guide review is not available because the CPSTF finding
is based on the following published systematic review:
The CPSTF identified several areas that have limited information. Additional research and evaluation
could help answer the following questions and fill remaining gaps in the evidence base. (What are
evidence gaps?)
How does effectiveness vary between specific programs in different populations (e.g., by race,
SES, educational attainment, age, cognitive or physical disabilities)?
How effective are programs delivered through the internet, email, apps, or social networking?
What is the relative effectiveness of individual and group sessions?
What structures and systems are needed to maintain program effectiveness and help participants
continue their improvements to diet and physical activity following program completion?
What are long-term effects on participants’ glycemic control, weight loss, cardiovascular disease
risk factors, morbidity, and mortality?
What are program attrition rates? Why do participants drop out, and how can they be retained?
Are these interventions effective with children and adolescents?
All included studies were randomized controlled trials.
Evaluated interventions provided a median of 11 sessions that were individual (3 studies) or a
combination of individual and group sessions (4 studies).
Studies evaluated interventions that provided patients specific, tailored instruction on lifestyle
changes through multiple interactions over extended periods of time.
Four of the programs provided additional, extended telephone contact and 2 of the programs had
frequent, ongoing contact with patients through regular exercise sessions.
The median intervention duration was 12 months. All 7 studies established clear goals for
patients’ dietary changes (3 studies), physical activity levels (5 studies), or weight loss (2 studies).
https://www.thecommunityguide.org/about/evidence-gaps
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.
Get custom essay samples and course-specific study resources via course hero homework for you service – Include d Studies
The number of studies and publications do not always correspond (e.g., a publication may include several studies
or one study may be explained in several publications).
Effectiveness Review
Studies from Huang et al. (2016: 2024 – Do my homework – Help write my assignment online) Get custom essay samples and course-specific study resources via course hero homework for you service – Include d in this Review
Ali M, Schifano F, Robinson P, Phillips G, Doherty L, Melnick P, et al. Impact of community pharmacy
diabetes monitoring and education programme on diabetes management: a randomized controlled
study. Diabet Med 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;29(9):e326–33.
Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al. Effect of an intensive exercise
intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes
mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;170:1794–803.
Chan CW, Siu SC, Wong CK, Lee VW. A pharmacist care program: positive impact on cardiac risk in
patients with type 2 diabetes. J Cardiovasc Pharmacol Ther 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;17:57–64.
Coppell KJ, KataokaM, Williams SM, Chisholm AW, Vorgers SM, Mann JI. Nutritional intervention in
patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle
Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial. BMJ 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;341:c3337.
Crasto W, Jarvis J, Khunti K, Skinner TC, Gray LJ, Brela J, et al. Multifactorial intervention in individuals
with type 2 diabetes and microalbuminuria: the Microalbuminuria Education and Medication
Optimisation (MEMO) study. Diabetes Res Clin Pract 2011;93: 328–36.
Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM,Wang NY, et al. Effect of exercise on blood
pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;27:1453–9.
Ko GT, Li JK, Kan EC, LoMK. Effects of a structured health education programme by a diabetic education
nurse on cardiovascular risk factors in Chinese type 2 diabetic patients: a 1-year prospective
randomized study. Diabet Med 2004;21:1274–9.
Kirk A, Mutrie N, MacIntyre P, Fisher M. Effects of a 12-month physical activity counselling
intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2
diabetes. Diabetologia 2004;47:821–32.
Krein SL, Klamerus ML, Vijan S, Lee JL, Fitzgerald JT, Pawlow A, et al. Case management for patients
with poorly controlled diabetes: a randomized trial. Am J Med 2004;116:732–9.
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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Search Strategies
Refer to the existing systematic review for information about the search strategy:
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37- 47.
Review References
Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2
diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016: 2024 – Do my homework – Help write my assignment online;27;37-47.
Considerations for Implementation
Look ARG, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk
factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch
Intern Med 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;170:1566–75.
Mohamed H, Al-Lenjawi B, Amuna P, Zotor F, Elmahdi H. Culturally sensitive patient-centred
educational programme for self-management of type 2 diabetes: a randomized controlled trial. Prim
Care Diabetes 2013;7:199–206.
Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martin-Madrazo
C, Rodes-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level
of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes
mellitus. BMC Public Health 2011;11:267.
Sevick MA, Korytkowski M, Stone RA, Piraino B, Ren D, Sereika S, et al. Biophysiologic outcomes of the
Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial. J Acad Nutr Diet 2014: 2024 – Essay Writing Service. Custom Essay Services Cheap;112:1147–57.
Sone H, Tanaka S, Iimuro S, Tanaka S, Oida K, Yamasaki Y, et al. Long-term lifestyle intervention
lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre
randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;53:419–28.
Trento M, Passera P, Bajardi M, Tomalino M, Grassi G, Borgo E, et al. Lifestyle intervention by group
care prevents deterioration of type II diabetes: a 4-year randomized controlled clinical trial.
Diabetologia 2002;45:1231–9.
Uusitupa M, Laitinen J, Siitonen O, Vanninen E, Pyorala K. The maintenance of improved metabolic
control after intensified diet therapy in recent type 2 diabetes. Diabetes Res Clin Pract 1993;19:227–38.
Wisse W, Boer Rookhuizen M, de Kruif MD, van Rossum J, Jordans I, ten Cate H, et al. Prescription of
physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2
diabetes patients. Diabetes Res Clin Pract 2010 – Essay Writing Service: Write My Essay by Top-Notch Writer;88:e10–3.
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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Crosswalks
Healthy People 2030
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.
The following considerations are drawn from studies included in the evidence review, the broader
literature, and expert opinion.
The U.S. Preventive Services Task Force (USPSTF) issued the following in 2015 – Research Paper Writing Help Service:
The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose as part of
cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should
offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to
promote a healthful diet and physical activity. (B recommendation: October 2015 – Research Paper Writing Help Service)
This recommendation will likely increase demand for early intervention to support patients in
making lifestyle changes and adopting long-term self-management behaviors.
Close coordination between healthcare systems, healthcare providers, and community-based
programs will likely be an essential element of sustainable community-based services.
Healthcare coverage for preventive services recommended by the USPSTF will likely be an
important source of funding for community-based programs once barriers to billing and
reimbursement are addressed.
Patients with, or at increased risk for, cardiovascular disease may need pre-intervention
assessments before initiating changes in physical activity, diet, and weight management.
Patients will need regular, ongoing diabetes care and medication management, which may
require adjustment as lifestyle changes are adopted.
Participants may be at increased risk for injuries associated with changes in physical
activity. This risk can be reduced if walking is emphasized as the primary mode of physical
activity with gradually increasing activity levels added as tolerated.
Reduce the proportion of adults with diabetes who have an A1c value above 9 percent — D‑03 (https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/reduce-proportion-adults-
diabetes-who-have-a1c-value-above-9-percent-d-03)
Increase the proportion of people with diabetes who get formal diabetes education — D‑06 (https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/increase-proportion-
people-diabetes-who-get-formal-diabetes-education-d-06)
https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/reduce-proportion-adults-diabetes-who-have-a1c-value-above-9-percent-d-03
https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/increase-proportion-people-diabetes-who-get-formal-diabetes-education-d-06
3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide
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The Community Guide
Page last reviewed: September 03, 2020
Page last updated: December 22, 2021
Content Source: The Guide to Community Preventive Services
Disclaimer:The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC. Task force evidence-based
recommendations are not mandates for compliance or spending. Instead, they provide
information and options for decision makers and stakeholders to consider when determining
which programs, services, and policies best meet the needs, preferences, available resources, and
constraints of their constituents.
Sample Citation: Guide to Community Preventive Services. Diabetes Management: Intensive Lifestyle Interventions
for Patients with Type 2 Diabetes. https://www.thecommunityguide.org/findings/diabetes-
intensive-lifestyle-interventions-patients-type-2-diabetes. Page last updated: December 22,
2021. Page accessed: March 2, 2022
@CPSTF (https://twitter.com/cpstf)
(404) 498-1827
communityguide@cdc.gov
Citation and Disclaimer
https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes
Tweets by CPSTF
tel:404-498-1827
mailto:communityguide@cdc.gov
—————-
3:22 p.m. on March 22nd Diabetes: Type 2 Lifestyle Programs | The Community Guide
https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 1/8
Systematic Evaluation
Topic Diabetes, Obesity
Recommended (suf�cient evidence)
Audience Adults, Older Adults
Setting Clinical/Health Systems, Community
Strategy Counseling, Health Education
Diabetes Management: Intensive Lifestyle Interventions for Patients with Type 2 Diabetes
October 2016: 2024 – Do my homework – Help write my assignment online
This webpage summarizes information available in the CPSTF Findings and Rationale Statement, located under the Snapshot tab.
The Community Guide (https://www.thecommunityguide.org)
Homework help – Summary of CPSTF Finding
The Community Preventive Services Task Force (CPSTF) recommends intensive lifestyle interventions for
patients with type 2 diabetes to improve glycemic control and reduce risk factors for cardiovascular
disease.
Intervention
CPSTF Finding and Rationale Statement
Intensive lifestyle interventions provide ongoing counseling, coaching, or individualized guidance to
patients with type 2 diabetes to help them
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