Evidence map›Paper›PMID 29874236›Full record

Trial reportPLoS medicine2018

A peer-support lifestyle intervention for preventing type 2 diabetes in India: A cluster-randomized controlled trial of the Kerala Diabetes Prevention Program.

Kavumpurathu R Thankappan, Thirunavukkarasu Sathish, Robyn J Tapp, Jonathan E Shaw, Mojtaba Lotfaliany, Rory Wolfe, Pilvikki Absetz, Elezebeth Mathews, Zahra Aziz, Emily D Williams and 8 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PLoS medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 9 pooled it
11.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 9 syntheses or guidelines pooled it, 183 citations in OpenAlex.

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45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 6 institutions in 5 countries.

Kavumpurathu R ThankappanAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.ORCID 0000-0002-4536-2684
Thirunavukkarasu SathishMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-2016-4964
Robyn J TappMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Jonathan E ShawBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia.ORCID 0000-0002-6187-2203
Mojtaba LotfalianyMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Rory WolfeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Pilvikki AbsetzInstitute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Elezebeth MathewsAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Zahra AzizMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.ORCID 0000-0002-1755-4187
Emily D WilliamsSchool of Health Sciences, University of Surrey, Guildford, Surrey, United Kingdom.
Edwin B FisherPeers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, North Carolina, United States of America.
Paul Z ZimmetBaker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Ajay MahalNossal Institute for Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Sajitha BalachandranAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
Fabrizio D'EspositoMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Priyanka SajeevAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.ORCID 0000-0001-8505-5008
Emma ThomasMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Brian OldenburgMelbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
The University of Melbourne · AUSree Chitra Thirunal Institute for Medical Sciences and Technology · INBaker Heart and Diabetes Institute · AUMonash University · AUUniversity of Eastern Finland · FIUniversity of Surrey · GB

Funding

Pilot and Feasibility ProgramP30DK092926 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$779k
FIC NIH HHS D43 TW008332NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

backgroundThe major efficacy trials on diabetes prevention have used resource-intensive approaches to identify high-risk individuals and deliver lifestyle interventions. Such strategies are not feasible for wider implementation in low- and middle-income countries (LMICs). We aimed to evaluate the effectiveness of a peer-support lifestyle intervention in preventing type 2 diabetes among high-risk individuals identified on the basis of a simple diabetes risk score. METHODS AND

findingsThe Kerala Diabetes Prevention Program was a cluster-randomized controlled trial conducted in 60 polling areas (clusters) of Neyyattinkara taluk (subdistrict) in Trivandrum district, Kerala state, India. Participants (age 30-60 years) were those with an Indian Diabetes Risk Score (IDRS) ≥60 and were free of diabetes on an oral glucose tolerance test (OGTT). A total of 1,007 participants (47.2% female) were enrolled (507 in the control group and 500 in the intervention group). Participants from intervention clusters participated in a 12-month community-based peer-support program comprising 15 group sessions (12 of which were led by trained lay peer leaders) and a range of community activities to support lifestyle change. Participants from control clusters received an education booklet with lifestyle change advice. The primary outcome was the incidence of diabetes at 24 months, diagnosed by an annual OGTT. Secondary outcomes were behavioral, clinical, and biochemical characteristics and health-related quality of life (HRQoL). A total of 964 (95.7%) participants were followed up at 24 months. Baseline characteristics of clusters and participants were similar between the study groups. After a median follow-up of 24 months, diabetes developed in 17.1% (79/463) of control participants and 14.9% (68/456) of intervention participants (relative risk [RR] 0.88, 95% CI 0.66-1.16, p = 0.36). At 24 months, compared with the control group, intervention participants had a greater reduction in IDRS score (mean difference: -1.50 points, p = 0.022) and alcohol use (RR 0.77, p = 0.018) and a greater increase in fruit and vegetable intake (≥5 servings/day) (RR 1.83, p = 0.008) and physical functioning score of the HRQoL scale (mean difference: 3.9 score, p = 0.016). The cost of delivering the peer-support intervention was US$22.5 per participant. There were no adverse events related to the intervention. We did not adjust for multiple comparisons, which may have increased the overall type I error rate.

conclusionsA low-cost community-based peer-support lifestyle intervention resulted in a nonsignificant reduction in diabetes incidence in this high-risk population at 24 months. However, there were significant improvements in some cardiovascular risk factors and physical functioning score of the HRQoL scale.

trial registrationAustralia and New Zealand Clinical Trials Registry ACTRN12611000262909.

Indexed as

CounselingLife StyleProgram EvaluationAdultCluster AnalysisDiabetes Mellitus, Type 2FemaleHealth PromotionHumansIndiaMaleMiddle Aged

Identifiers

PMID29874236
PMCPMC5991386
OpenAlexW2805991586

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.