Diabetes risk reduction in overweight first degree relatives of type 2 diabetes patients: Effects of a low-intensive lifestyle education program (DiAlert) A randomized controlled trial

Objectives
To test the efficacy of a low-intensive lifestyle education program (DiAlert) for overweight first degree relatives of type 2 diabetes patients aimed at reducing diabetes risk.

Methods
Overweight first degree relatives of type 2 diabetes patients were randomly assigned to the DiAlert intervention (N = 45) or control group who received leaflets (N = 51). DiAlert consists of two group sessions and newsletters. Assessments were scheduled at baseline, three and nine months, with weight loss as primary outcome. Secondary outcomes included anthropometric, metabolic, behavioral and psychological measures. Comparisons were made over time and between groups.

Results
Both groups showed modest weight loss with no difference between randomization groups. However, after DiAlert significantly more participants lost 5% of their weight compared to controls (P = 0.03). Significant improvement of waist circumference sustained after 9 months in the intervention group (intervention: −4.33 cm, P < 0.01/control: −1.25 cm, P = 0.08). Systolic blood pressure improved within the intervention group (intervention: −8.77 mmHg, P < 0.01/control: −1.03 mmHg, P = 0.60). No effect was observed for biomedical and psychosocial outcomes.

Conclusions
Our low-intensive structured lifestyle education program helps overweight relatives to improve waist circumference and supports relevant weight loss.

Practice implications
The family approach provides opportunities to reach and engage relatives at risk in diabetes prevention education.