Diabetes is responsible for millions deaths globally among adults and two-thirds of the diabetes-attributable deaths occurring in developing countries over the past decades. Among the top leading causes of death in Taiwan, both the rates and numbers of diabetes have begun a steep ascent in recent years. The increasing burden of diabetes is alarming because of its broad spectrum of acute and long-term complications imposing substantial human and economic costs on individuals, families, health care systems, and society. Lifestyle intervention has been proved a cost-effective approach for diabetes prevention among the pre-diabetics adults who are overweight or with an impaired glucose tolerance.
A modified Diabetes Prevention Program (DPP) consists of 12 modules, which had been tailored to a group of pre-diabetic Chinese immigrants living in the Chinatown of New York City, was pilot-tested in a mental hospital in central Taiwan. A total of 50 subjects (mean age =51.5) were randomized into the intervention (receiving the 12-module DPP)and control (receiving no intervention) groups and their Body Mass Index (BMI), physical activities and other psychosocial variables were measured before and after the intervention.
The differences in the measured variables between pre- and post-test were evaluated by using Paired-t tests. A significant reduction in the mean BMI (from 27.15 to 26.10 kg/m², p = 0.033) was found in the intervention group (N=26). For the subjects in the control group (N=24), their BMI also improved, but did not reach the 0.05-level of significance. For other measures, however, no significant differences were observed in both the intervention and control groups between the pre- and post-tests.
The results indicate that a modified Diabetes Prevention Program to patients of a mental hospital in central Taiwan had only a modest impact on some measures of risk factors to diabetes. It is speculated that the program’s low effectiveness, for this vulnerable population, was due to the patients’ impaired cognitive functioning resulting from their mental diseases and long-term hospitalization. The low cognitive and social skills among these patients led to a low motivation and ability to implement the life style changes needed for maintaining good health. Special strategies are needed for future applications of the DPP program to this low health-literacy group.
