Type 2 Diabetes Clinical Trial
Official title:
Evaluation of a Lifestyle Intervention to Prevent Type 2 Diabetes/Metabolic Syndrome Among Pakistani Immigrants - Focusing on Changes in Diet and Physical Activity
Immigrants from South Asia in Norway have a high prevalence of type 2 diabetes and conditions related to the metabolic syndrome. It has been documented that these conditions may be prevented by changes in lifestyle. No previous intervention studies on immigrants with focus on diet and physical activity have been carried out in Norway. This project concerns a randomized controlled trial with intervention to change diet and physical activity in 200 high risk female Pakistani immigrants living in Oslo. The intervention will be evaluated both in terms of outcome and process.
Objectives:
1. To evaluate the health effects of systematic dietary education and counselling and
physical training in a group of Pakistani women with high risk of type 2 diabetes.
2. To evaluate the intervention process in order to identify the most effective methods of
intervention in regard to diet and physical activity for immigrant women of Pakistani
origin.
Background: Immigrants from South Asia have a high prevalence of type 2 diabetes, which may
be prevented by intensive on physical activity and diet. This application concerns
intervention with diet and physical activity in female (ongoing study) and male (extended
study) Pakistani immigrants living in Oslo to reduce their risk for these diseases.
Intervention design: The subjects will be 200 women randomized into an intervention group
and a control group (100 in each). The women are being recruited from a township in Oslo
with a high proportion of immigrants by using a network approach. Inclusion criteria is
based on a risk score developed by Ramachandran et al for Asian Indians, entailing age, Body
Mass Index, waist circumference, family history of diabetes and sedentary physical activity.
The intervention will include a combination of individual counselling and group sessions.
The intervention group will be divided into subgroups of 10-12 subjects. Each subgroup will
have 10 group sessions on diet/lifestyle in the 6 months the intervention period lasts, and
will additionally have the possibility to join a cultural adapted exercise program of low
intensity twice a week. This includes indoor activities (exercise with music) and outdoor
activities (walking groups).
Evaluation: The main end point of the intervention will be the fasting and 2-h plasma
glucose value after an oral glucose tolerance test (OGTT). This will be measured at baseline
and after 6 months of intervention.
Secondary end-points will be Serum lipid profile (e.g. triglycerides, High-Density
Lipoprotein-cholesterol) ; HbA1c ; C-peptide ; serum insulin; serum albumin; body weight;
waist and hip circumference; maximum heart rate on treadmill test; self-reported level of
intensity, duration and frequency of physical activity; self-reported level of "Stages of
change" in regard to motivation and behavioural change; self- reported subjective health
complaints; self-reported coping strategies; self-reported sleeping habits.
Dietary information will be collected by 2 x 48 hours dietary recalls. The intake of energy
and nutrients will be calculated from the recalls, as well as the intake of food groups.The
diet will also be evaluated by a culturally adapted food frequency questionnaire including
20 food groups (with portion sizes). In addition, the use of cooking oils will be registered
by questions about the type and quantity oil used per time unit in the household.
Additionally, information on knowledge and perceptions on diet and health before and after
the intervention will be registered.
Physical activity will be registered using an advanced continuous body monitor, SenseWear
Armband yielding information on total energy expenditure, level of intensity, duration and
frequency of physical activity, duration of lying down, duration of sleeping, and sleeping
quality.
The completion of the questionnaires will take the form of an interview by Urdu speaking
staff.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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