Adherence
Comprehensive lifestyle interventions (LI) that incorporate multiple cornerstones of Type 2 Diabetes (T2D) management reduce HbA1c in research settings, but face a 'scale-up penalty' of 22-35% when translated to real-world primary care settings.
If you are managing T2D through lifestyle changes, expect that maintaining these changes in your daily life (real-world) is harder than following a plan in a structured program (research). The benefits are still there, but they may be about 20-35% less pronounced than in clinical trials. To maximize results, focus on integrating the core habits (diet, activity, monitoring) into your existing routine rather than trying to replicate the intensity of a clinical trial.
The main results of the systematic review found that all the studies analyzed reported a decrease in HbA1c values in the intervention group and that a scale-up penalty was detected ranging from 22 to 35%. Furthermore, comprehensive LI that incorporated most of the cornerstones of T2D management reduced HbA1c in research settings and generally sustained those benefits in real-world setting, albeit with a scale-up penalty under some circumstances.
Why this rating
Based on a systematic review of multiple studies and a specific RCT, though the RCT itself showed no significant within-group change.
Source
The Pure Prairie Living Program for Type 2 Diabetes: Evaluation and Steps to Optimize and Enhance Participant Success
M. Carolina Archundia Herrera · University of Alberta Library · 2021
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