Impact of a Novel Diabetes Prevention Intervention for Early Slow Weight Loss Responders Among Adults With Prediabetes: An Adaptive Trial

Abstract

OBJECTIVE Some people are slower to respond during lifestyle interventions. An adaptive “rescue” intervention may improve outcomes among slow responders. The impact of a worksite rescue intervention for early slow responders was evaluated. RESEARCH DESIGN AND METHODS Employees ≥21 years old with prediabetes were stratified to intervention using a 2.5% weight loss (%WL) threshold at week 5. Outcomes were assessed at baseline and at 4 months using mixed-effect and linear regression models. RESULTS Significant improvement occurred in mean %WL, glycemia, total cholesterol, and triglycerides in the standard compared with the adaptive (Group Lifestyle Balance Plus [GLB+]) intervention (all P≤ 0.01). However, GLB+ participants also experienced a significant reduction in %WL and glycemia (all P < 0.01). The %WL at week 5 significantly predicted %WL at 4 months (P < 0.0001). The between-group difference of 4-month %WL was not significant for someone achieving 2.5%WL at week 5. CONCLUSIONS Diabetes prevention programs should consider weight loss success following 1 month of treatment and offer a rescue intervention to early slow weight loss responders.