Evidence mapPaperPMID 40970814Full record

Trial reportDiabetes care2025

Effectiveness of an Incentives-Enhanced Stepped Care Intervention Program in Diabetes Prevention in a Multiethnic Asian Prediabetes Cohort: Results From the Pre-DICTED Randomized Controlled Trial.

Yong Mong Bee, Neha Awasthi, Mihir Gandhi, Amanda Yun Rui Lam, Selly Julianty, Gilbert Choon Seng Tan, Emily Tse Lin Ho, Su-Yen Goh, Gavin Siew Wei Tan, Eugene Jin Wen Shum and 7 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
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

17 authors.

Yong Mong BeeDepartment of Endocrinology, Singapore General Hospital, Singapore.ORCID 0000-0002-5482-2646
Neha AwasthiBiostatistics, Singapore Clinical Research Institute, Singapore.
Mihir GandhiBiostatistics, Singapore Clinical Research Institute, Singapore.
Amanda Yun Rui LamDepartment of Endocrinology, Singapore General Hospital, Singapore.
Selly JuliantyRegional Health System Office, SingHealth, Singapore.
Gilbert Choon Seng TanSingHealth Polyclinics, Singapore.
Emily Tse Lin HoDepartment of Endocrinology, Singapore General Hospital, Singapore.
Su-Yen GohDepartment of Endocrinology, Singapore General Hospital, Singapore.
Gavin Siew Wei TanSurgical Retinal Department, Singapore National Eye Centre, Singapore.
Eugene Jin Wen ShumRegional Health System Office, SingHealth, Singapore.
Yu Qi LeeSaw Swee Hock School of Public Health, NUS, Singapore.
Mary Foong Fong ChongSaw Swee Hock School of Public Health, NUS, Singapore.
Tazeen H JafarHealth Services and Systems Research, Duke-NUS Medical School, Singapore.
Rob M van DamSaw Swee Hock School of Public Health, NUS, Singapore.
Yee Leong TeohOffice of Healthcare Transformation, Ministry of Health, Singapore.
Julian ThumbooMedicine Academic Clinical Programme, Duke-National University of Singapore (NUS) Medical School, Singapore.
Eric Andrew FinkelsteinHealth Services and Systems Research, Duke-NUS Medical School, Singapore.ORCID 0000-0001-6443-9686

Funding

Ministry of Health -Singapore
6 · The paper itself

Abstract

objectiveDiabetes prevention in real-world settings is affected by the challenge of intervention adherence and difficulty in sustaining behavior change. This study evaluated the effectiveness of a stepped care prevention program, enhanced with financial incentives, in reducing the risk of diabetes conversion in a multiethnic prediabetes cohort in Singapore. RESEARCH DESIGN AND

methodsThe Pre-Diabetes Interventions and Continued Tracking to Ease Out Diabetes (Pre-DICTED) trial was a randomized controlled trial involving 751 overweight or obese individuals with impaired glucose tolerance, impaired fasting glucose, or both. Participants were assigned to standard care (control arm) or a stepped care intervention program, starting with lifestyle interventions for 6 months before adding metformin for participants who remained at high risk of diabetes conversion based on study visit assessments. Intervention arm participants also received financial incentives for attending lifestyle sessions and for achieving ≥5% weight loss. The primary end point was the proportion of participants developing diabetes at 3 years in the modified intention-to-treat population.

resultsAfter 3 years, 34.8% of participants in the intervention arm developed diabetes compared with 47.3% in the control arm (adjusted risk difference -10.93%; 95% CI -18.04 to -3.81; P = 0.003). The adjusted relative risk was 0.74 (95% CI 0.62-0.88; P < 0.001). In the intervention arm, 26.4% of participants received metformin, and 45.1% received cash incentives. Adverse events were more common in the intervention arm, mainly because of metformin-related gastrointestinal symptoms.

conclusionsA stepped care diabetes prevention program, enhanced with financial incentives, effectively reduced diabetes conversion in a multiethnic Asian prediabetes cohort.

Indexed as

Diabetes Mellitus, Type 2MotivationPrediabetic StateAdultAgedAsian PeopleFemaleHumansLife StyleMaleMetforminMiddle AgedSingaporeMetformin

Identifiers

PMID40970814
PMCPMC12583383

What Socratic holds

Texttitle and abstract
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.