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Sustained Effectiveness of Shared Decision-making for Diabetes Prevention Interventions

Weight loss was maintained for up to 36 months in patients with overweight/obesity and prediabetes who participated in shared decision-making (SDM) for diabetes prevention, researchers report. While the difference in diabetes incidence was not significant compared with a matched historical control group, the authors conclude, “This is one of the first longitudinal studies to demonstrate modest, persistent weight loss after brief diabetes prevention SDM, and the results support a potential role for SDM in diabetes prevention.”

In the cluster-randomized PRIDE trial, participants in 20 practices were offered the Diabetes Prevention Program (DPP)/intensive lifestyle change, metformin, or both, by pharmacists trained in motivational interviewing, SDM, and use of the Healthwise diabetes prevention decision aid, “Prediabetes: Which Treatment Should I Use?” Weight loss was measured at 24 and 36 months of follow-up, and diabetes incidence was measured at 36 months.

“In adjusted post hoc analyses, SDM participants (n = 489) maintained modestly greater 24-month weight loss of −3.1 lb and 36-month weight loss of −2.7 lb versus controls (n = 1,430, both comparisons P < 0.001). SDM participants who chose both lifestyle change and metformin sustained weight loss at 36 months of −4.1 lb (P < 0.001 vs. controls). We found no differences in incident diabetes (15% of SDM participants, 14% of control participants; P = 0.64).”

Source: Diabetes Care