iHealth-T2D approaches to health promotion for prevention of T2D are innovative and not addressed by previous or on-going studies in South Asians.
However, other studies in European populations, show that intensive lifestyle modifications comprising increased physical activity, dietary change and weight loss is associated with a 30-60% reduction in the incidence of T2D amongst people identified to be at high risk.
The study focus on South Asian men and women living in India, Sri Lanka, Pakistan and United Kingdom. Our study participants are from major cultural subgroups and from diverse social and economic backgrounds.
We chose waist circumference and HbA1c to identify South Asians at risk of T2D. Waist circumference is a simple, readily available physical measure of T2D risk, while HbA1c is a robust, highly-discriminatory blood biomarker of T2D risk that does not require a fasting sample. Our thresholds of waist≥100cm and HbA1c≥6.0% are based on WHO guidelines and on results from our prospective population studies.
Study participants are randomly allocated to intervention and control arm. Participants in control arm receive a single clinic session, delivered by our community health workers and dieticians and are followed up annually, for three years. Participants in the intervention group, are closely accompanied by our team throughout a year, receiving personalised diet plans and health advice. At the end of the one year intervention, participants are followed up annually, for three years.
iHealth-T2D focus on family-based approach, meaning that we encourage all participants to involve their family members in the clinic sessions and in physical activities. This approach is based on published evidence and our own data from the UK, which indicates superior clinical effectiveness for weight loss compared to individually-administered lifestyle modification.
The study design: