human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of the present study was to evaluate the impact of a lifestyle intervention programme , combined with a daily low-glycaemic index meal replacement , on body-weight and glycaemic control in subjects with impaired glucose regulation ( IGR ) . Subjects with IGR were r and omly assigned to an intervention group ( n 46 ) and a control group ( n 42 ) . Both groups received health counselling at baseline . The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study , and follow-up visits performed monthly until the end of the 1-year study . Outcome measurements included changes in plasma glucose , glycated Hb ( HbA1c ) , plasma lipids , body weight , blood pressure and body composition ( such as body fat mass and visceral fat area ) . The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group ( -1·8 ( SEM 0·35 ) v. -0·6 ( SEM 0·40 ) 2·5 kg , P<0·05 ) . The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group ( P<0·05 ) compared with their baseline , respectively . A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose ( P<0·01 ) . The incidence of normal glucose regulation ( NGR ) in the two groups was significantly different ( P=0·001 ) . In conclusion , the combination of regular contact , lifestyle advice and meal replacement is beneficial in promoting IGR to NGR Although evidence suggests that lifestyle interventions can reduce blood pressure ( BP ) and glucose levels , there is little information about the feasibility of such interventions when implemented in community setting s. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose in the middle-aged and older Chinese population . By using a cluster r and omisation approach , 474 participants from two communities were assigned to the intervention group which received intensive health education and behavioural intervention , or the control group which received conventional education . Linear mixed models were used to compare between-group differences on change in BP and fasting glucose after 6 , 12 and 24 months . At the 12-month follow-up , the intervention group experienced significantly reductions in systolic BP ( −4.9 vs. 2.4 mmHg ; mean difference [ MD ] −7.3 mmHg ; p < 0.001 ) , diastolic BP ( −1.9 vs. 1.9 mmHg ; MD −3.8 mmHg ; p < 0.001 ) and fasting glucose ( −0.59 vs. 0.08 mmol/L ; MD −0.67 mmol/L ; p < 0.001 ) . These differences were sustained at the 24-month follow-up . With only two communities , it was not possible to adjust for potential clustering by site . This approach of lifestyle interventions conducted through primary care services may be a potential solution for combating hypertension and diabetes in a re source -limited country context in China BACKGROUND The Diabetes Prevention Program ( DPP ) found that an intensive lifestyle intervention can reduce the development of diabetes by more than half in adults with prediabetes , but there is little information about the feasibility of offering such an intervention in community setting s. This study evaluated the delivery of a group-based DPP lifestyle intervention in partnership with the YMCA . METHODS This pilot cluster-r and omized trial was design ed to compare group-based DPP lifestyle intervention delivery by the YMCA to brief counseling alone ( control ) in adults who attended a diabetes risk-screening event at one of two semi-urban YMCA facilities and who had a BMI > or=24 kg/m2 , > or=2 diabetes risk factors , and a r and om capillary blood glucose of 110 - 199 mg/dL. Multivariate regression was used to compare between-group differences in changes in body weight , blood pressures , HbA1c , total cholesterol , and HDL-cholesterol after 6 and 12 months . RESULTS Among 92 participants , controls were more often women ( 61 % vs 50 % ) and of nonwhite race ( 29 % vs 7 % ) . After 6 months , body weight decreased by 6.0 % ( 95 % CI=4.7 , 7.3 ) in intervention participants and 2.0 % ( 95 % CI=0.6 , 3.3 ) in controls ( p<0.001 ; difference between groups ) . Intervention participants also had greater changes in total cholesterol ( -22 mg/dL vs + 6 mg/dL controls ; p<0.001 ) . These differences were sustained after 12 months , and adjustment for differences in race and gender did not alter these findings . With only two matched YMCA sites , it was not possible to adjust for potential clustering by site . CONCLUSIONS The YMCA may be a promising channel for wide-scale dissemination of a low-cost approach to lifestyle diabetes prevention AIM To determine the efficacy of delivering short-message service ( SMS ) to provide diabetes-related information in reducing the risk of developing diabetes in Chinese professional drivers with pre-diabetes . METHODS A pilot single-blinded r and omized controlled trial was conducted in Hong Kong between 05/2009 and 04/2012 . Professional drivers with impaired glucose tolerance ( IGT ) were r and omly allocated to either a SMS group receiving messages comprising knowledge and lifestyle modification on diabetes or to a control group with usual care . Primary outcomes were the incidence rate of diabetes mellitus over 12 and 24 months period . RESULTS Fifty-four , out of 104 professional drivers recruited , were r and omly allocated to intervention group . Fewer subjects developed diabetes at 12 months in intervention group ( 5.56 % ) compared to control group ( 16.00 % ) . Relative risk ( RR ) of diabetes onset was 0.35 ( 95%CI : 0.10–1.24 ) and the number needed to treat ( NNT ) for preventing one diabetes was 9.57 . At 24 months , RR increased to 0.62 ( 95%CI : 0.24–1.61 ) with a NNT of 10.58 . Logistic regression showed a significant odds ratio of 0.04 ( P = 0.021 ) for intervention group compared to control group at 12-month follow-up for completers and a non-significant odds ratio of 0.34 ( P = 0.303 ) at 24-month follow-up . CONCLUSIONS The SMS program proved to have potential to reduce the risk of developing diabetes at 12 months but additional measures should be integrated to prevent or delay disease progression AIMS To investigate a virtual assistance-based lifestyle intervention to reduce risk factors for Type 2 diabetes in young employees in the information technology industry in India . METHODS LIMIT ( Lifestyle Modification in Information Technology ) was a parallel-group , partially blinded , r and omized controlled trial . Employees in the information technology industry with ≥3 risk factors ( family history of cardiometabolic disease , overweight/obesity , high blood pressure , impaired fasting glucose , hypertriglyceridaemia , high LDL cholesterol and low HDL cholesterol ) from two industries were r and omized to a control or an intervention ( 1:1 ) group . After initial lifestyle advice , the intervention group additionally received reinforcement through mobile phone messages ( three per week ) and e-mails ( two per week ) for 1 year . The primary outcome was change in prevalence of overweight/obesity , analysed by intention to treat . RESULTS Of 437 employees screened ( mean age 36.2 ± 9.3 years ; 74.8 % men ) , 265 ( 61.0 % ) were eligible and r and omized into control ( n=132 ) or intervention ( n=133 ) group . After 1 year , the prevalence of overweight/obesity reduced by 6.0 % in the intervention group and increased by 6.8 % in the control group ( risk difference 11.2 % ; 95 % CI 1.2 - 21.1 ; P=0.042 ) . There were also significant improvements in lifestyle measurements , waist circumference , and total and LDL cholesterol in the intervention group . The number-needed-to-treat to prevent one case of overweight/obesity in 1 year was 9 ( 95 % CI 5 - 82 ) , with an incremental cost of INR10665 ( £ 112.30 ) per case treated/prevented . A total of 98 % of participants found the intervention acceptable . CONCLUSIONS A virtual assistance-based lifestyle intervention  was effective , cost-effective and acceptable in reducing risk factors for diabetes in young employees in the information technology industry , and is potentially scalable Objective : The objective of this study was to evaluate the effectiveness of a synthetic intervention model aim ed at preventing type 2 diabetes and controlling plasma glucose , body weight and waist circumference in elderly individuals with prediabetes in rural China . Methods : We r and omly assigned 434 ( 180 men and 254 women ; mean age , 69 years ; mean body mass index , 23.6 kg/m2 ) with prediabetes to either the intervention group or the control group . Each participant in the intervention group received synthetic intervention for 1 year . Results : The incidence of diabetes was 4.2 % in the intervention group , versus 19.7 % in the control group at the end of 1 year ( p < 0.001 ) . Compared with the control group , the intervention group experienced a great decrease in fasting glucose ( −3.9 vs. 2.2 mg/dL , p < 0.001 ) , body weight ( −3.2 vs. 1.7 kg , p < 0.001 ) , waist circumference ( −2.4 vs. 1.0 cm , p < 0001 ) , total cholesterol ( −9.1 vs. −4.6 mg/dL. p = 0.014 ) and HbA1c ( −1.0 vs. 0.1 mg % , p = 0.002 ) at the end of 1 year . Conclusions : The incidence of diabetes of the control group was higher than that of the intervention group . Besides , the synthetic intervention contributes to weight loss and glucose decrease , and may be effective in reducing the risk of diabetes among elderly individuals with prediabetes in rural China BACKGROUND In the 2.8 years of the Diabetes Prevention Program ( DPP ) r and omised clinical trial ,  diabetes incidence  in high-risk adults was reduced by 58 % with intensive lifestyle intervention and by 31 % with metformin , compared with placebo . We investigated the persistence of these effects in the long term . METHODS All active DPP participants were eligible for continued follow-up . 2766 of 3150 ( 88 % ) enrolled for a median additional follow-up of 5.7 years ( IQR 5.5 - 5.8 ) . 910 participants were from the lifestyle , 924 from the metformin , and 932 were from the original placebo groups .  On the basis of the benefits from the intensive lifestyle intervention in the DPP , all three groups were offered group-implemented lifestyle intervention . Metformin treatment was continued in the original metformin group ( 850 mg twice daily as tolerated ) , with participants unmasked to assignment , and the original lifestyle intervention group was offered additional lifestyle support . The primary outcome was development of diabetes according to American Diabetes Association criteria . Analysis was by intention-to-treat . This study is registered with Clinical Trials.gov , number NCT00038727 . FINDINGS During the 10.0-year ( IQR 9.0 - 10.5 ) follow-up since r and omisation to DPP , the original lifestyle group lost , then partly regained weight . The modest weight loss with metformin was maintained . Diabetes incidence rates during the DPP were 4.8 cases per 100 person-years ( 95 % CI 4.1 - 5.7 ) in the intensive lifestyle intervention group , 7.8 ( 6.8 - 8.8 ) in the metformin group , and 11.0 ( 9.8 - 12.3 ) in the placebo group . Diabetes incidence rates in this follow-up study were similar between treatment groups : 5.9 per 100 person-years ( 5.1 - 6.8 ) for lifestyle , 4.9 ( 4.2 - 5.7 ) for metformin , and 5.6 ( 4.8 - 6.5 ) for placebo . Diabetes incidence in the 10 years since DPP r and omisation was reduced by 34 % ( 24 - 42 ) in the lifestyle group and 18 % ( 7 - 28 ) in the metformin group compared with placebo . INTERPRETATION During follow-up after DPP , incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group , but the cumulative incidence of diabetes remained lowest in the lifestyle group . Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years 
    Output:
    
agent
Conclusion Based on available literature , evidence suggests that community-based interventions may reduce the incidence rate of T2DM and may positively affect anthropometric indices and HbA1C .
Due to the heterogeneity observed between trials we recommend more well- design ed RCTs with longer follow-up duration s be executed , to confirm whether community-based interventions lead to reduced T2DM events in the at-risk population of LMIC setting
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The purpose of the present study was to evaluate the impact of a lifestyle intervention programme , combined with a daily low-glycaemic index meal replacement , on body-weight and glycaemic control in subjects with impaired glucose regulation ( IGR ) . Subjects with IGR were r and omly assigned to an intervention group ( n 46 ) and a control group ( n 42 ) . Both groups received health counselling at baseline . The intervention group also received a daily meal replacement and intensive lifestyle intervention to promote healthy eating habits during the first 3 months of the study , and follow-up visits performed monthly until the end of the 1-year study . Outcome measurements included changes in plasma glucose , glycated Hb ( HbA1c ) , plasma lipids , body weight , blood pressure and body composition ( such as body fat mass and visceral fat area ) . The results showed that body-weight loss after 1 year was significant in the intervention group compared with the control group ( -1·8 ( SEM 0·35 ) v. -0·6 ( SEM 0·40 ) 2·5 kg , P<0·05 ) . The 2 h plasma glucose concentration decreased 1·24 mmol/l in the intervention group and increased 0·85 mmol/l in the control group ( P<0·05 ) compared with their baseline , respectively . A 5 kg body-weight loss at 1 year was associated with a decrease of 1·49 mmol/l in 2 h plasma glucose ( P<0·01 ) . The incidence of normal glucose regulation ( NGR ) in the two groups was significantly different ( P=0·001 ) . In conclusion , the combination of regular contact , lifestyle advice and meal replacement is beneficial in promoting IGR to NGR Although evidence suggests that lifestyle interventions can reduce blood pressure ( BP ) and glucose levels , there is little information about the feasibility of such interventions when implemented in community setting s. This study evaluated the effectiveness of a community-based lifestyle intervention on BP and glucose in the middle-aged and older Chinese population . By using a cluster r and omisation approach , 474 participants from two communities were assigned to the intervention group which received intensive health education and behavioural intervention , or the control group which received conventional education . Linear mixed models were used to compare between-group differences on change in BP and fasting glucose after 6 , 12 and 24 months . At the 12-month follow-up , the intervention group experienced significantly reductions in systolic BP ( −4.9 vs. 2.4 mmHg ; mean difference [ MD ] −7.3 mmHg ; p < 0.001 ) , diastolic BP ( −1.9 vs. 1.9 mmHg ; MD −3.8 mmHg ; p < 0.001 ) and fasting glucose ( −0.59 vs. 0.08 mmol/L ; MD −0.67 mmol/L ; p < 0.001 ) . These differences were sustained at the 24-month follow-up . With only two communities , it was not possible to adjust for potential clustering by site . This approach of lifestyle interventions conducted through primary care services may be a potential solution for combating hypertension and diabetes in a re source -limited country context in China BACKGROUND The Diabetes Prevention Program ( DPP ) found that an intensive lifestyle intervention can reduce the development of diabetes by more than half in adults with prediabetes , but there is little information about the feasibility of offering such an intervention in community setting s. This study evaluated the delivery of a group-based DPP lifestyle intervention in partnership with the YMCA . METHODS This pilot cluster-r and omized trial was design ed to compare group-based DPP lifestyle intervention delivery by the YMCA to brief counseling alone ( control ) in adults who attended a diabetes risk-screening event at one of two semi-urban YMCA facilities and who had a BMI > or=24 kg/m2 , > or=2 diabetes risk factors , and a r and om capillary blood glucose of 110 - 199 mg/dL. Multivariate regression was used to compare between-group differences in changes in body weight , blood pressures , HbA1c , total cholesterol , and HDL-cholesterol after 6 and 12 months . RESULTS Among 92 participants , controls were more often women ( 61 % vs 50 % ) and of nonwhite race ( 29 % vs 7 % ) . After 6 months , body weight decreased by 6.0 % ( 95 % CI=4.7 , 7.3 ) in intervention participants and 2.0 % ( 95 % CI=0.6 , 3.3 ) in controls ( p<0.001 ; difference between groups ) . Intervention participants also had greater changes in total cholesterol ( -22 mg/dL vs + 6 mg/dL controls ; p<0.001 ) . These differences were sustained after 12 months , and adjustment for differences in race and gender did not alter these findings . With only two matched YMCA sites , it was not possible to adjust for potential clustering by site . CONCLUSIONS The YMCA may be a promising channel for wide-scale dissemination of a low-cost approach to lifestyle diabetes prevention AIM To determine the efficacy of delivering short-message service ( SMS ) to provide diabetes-related information in reducing the risk of developing diabetes in Chinese professional drivers with pre-diabetes . METHODS A pilot single-blinded r and omized controlled trial was conducted in Hong Kong between 05/2009 and 04/2012 . Professional drivers with impaired glucose tolerance ( IGT ) were r and omly allocated to either a SMS group receiving messages comprising knowledge and lifestyle modification on diabetes or to a control group with usual care . Primary outcomes were the incidence rate of diabetes mellitus over 12 and 24 months period . RESULTS Fifty-four , out of 104 professional drivers recruited , were r and omly allocated to intervention group . Fewer subjects developed diabetes at 12 months in intervention group ( 5.56 % ) compared to control group ( 16.00 % ) . Relative risk ( RR ) of diabetes onset was 0.35 ( 95%CI : 0.10–1.24 ) and the number needed to treat ( NNT ) for preventing one diabetes was 9.57 . At 24 months , RR increased to 0.62 ( 95%CI : 0.24–1.61 ) with a NNT of 10.58 . Logistic regression showed a significant odds ratio of 0.04 ( P = 0.021 ) for intervention group compared to control group at 12-month follow-up for completers and a non-significant odds ratio of 0.34 ( P = 0.303 ) at 24-month follow-up . CONCLUSIONS The SMS program proved to have potential to reduce the risk of developing diabetes at 12 months but additional measures should be integrated to prevent or delay disease progression AIMS To investigate a virtual assistance-based lifestyle intervention to reduce risk factors for Type 2 diabetes in young employees in the information technology industry in India . METHODS LIMIT ( Lifestyle Modification in Information Technology ) was a parallel-group , partially blinded , r and omized controlled trial . Employees in the information technology industry with ≥3 risk factors ( family history of cardiometabolic disease , overweight/obesity , high blood pressure , impaired fasting glucose , hypertriglyceridaemia , high LDL cholesterol and low HDL cholesterol ) from two industries were r and omized to a control or an intervention ( 1:1 ) group . After initial lifestyle advice , the intervention group additionally received reinforcement through mobile phone messages ( three per week ) and e-mails ( two per week ) for 1 year . The primary outcome was change in prevalence of overweight/obesity , analysed by intention to treat . RESULTS Of 437 employees screened ( mean age 36.2 ± 9.3 years ; 74.8 % men ) , 265 ( 61.0 % ) were eligible and r and omized into control ( n=132 ) or intervention ( n=133 ) group . After 1 year , the prevalence of overweight/obesity reduced by 6.0 % in the intervention group and increased by 6.8 % in the control group ( risk difference 11.2 % ; 95 % CI 1.2 - 21.1 ; P=0.042 ) . There were also significant improvements in lifestyle measurements , waist circumference , and total and LDL cholesterol in the intervention group . The number-needed-to-treat to prevent one case of overweight/obesity in 1 year was 9 ( 95 % CI 5 - 82 ) , with an incremental cost of INR10665 ( £ 112.30 ) per case treated/prevented . A total of 98 % of participants found the intervention acceptable . CONCLUSIONS A virtual assistance-based lifestyle intervention  was effective , cost-effective and acceptable in reducing risk factors for diabetes in young employees in the information technology industry , and is potentially scalable Objective : The objective of this study was to evaluate the effectiveness of a synthetic intervention model aim ed at preventing type 2 diabetes and controlling plasma glucose , body weight and waist circumference in elderly individuals with prediabetes in rural China . Methods : We r and omly assigned 434 ( 180 men and 254 women ; mean age , 69 years ; mean body mass index , 23.6 kg/m2 ) with prediabetes to either the intervention group or the control group . Each participant in the intervention group received synthetic intervention for 1 year . Results : The incidence of diabetes was 4.2 % in the intervention group , versus 19.7 % in the control group at the end of 1 year ( p < 0.001 ) . Compared with the control group , the intervention group experienced a great decrease in fasting glucose ( −3.9 vs. 2.2 mg/dL , p < 0.001 ) , body weight ( −3.2 vs. 1.7 kg , p < 0.001 ) , waist circumference ( −2.4 vs. 1.0 cm , p < 0001 ) , total cholesterol ( −9.1 vs. −4.6 mg/dL. p = 0.014 ) and HbA1c ( −1.0 vs. 0.1 mg % , p = 0.002 ) at the end of 1 year . Conclusions : The incidence of diabetes of the control group was higher than that of the intervention group . Besides , the synthetic intervention contributes to weight loss and glucose decrease , and may be effective in reducing the risk of diabetes among elderly individuals with prediabetes in rural China BACKGROUND In the 2.8 years of the Diabetes Prevention Program ( DPP ) r and omised clinical trial ,  diabetes incidence  in high-risk adults was reduced by 58 % with intensive lifestyle intervention and by 31 % with metformin , compared with placebo . We investigated the persistence of these effects in the long term . METHODS All active DPP participants were eligible for continued follow-up . 2766 of 3150 ( 88 % ) enrolled for a median additional follow-up of 5.7 years ( IQR 5.5 - 5.8 ) . 910 participants were from the lifestyle , 924 from the metformin , and 932 were from the original placebo groups .  On the basis of the benefits from the intensive lifestyle intervention in the DPP , all three groups were offered group-implemented lifestyle intervention . Metformin treatment was continued in the original metformin group ( 850 mg twice daily as tolerated ) , with participants unmasked to assignment , and the original lifestyle intervention group was offered additional lifestyle support . The primary outcome was development of diabetes according to American Diabetes Association criteria . Analysis was by intention-to-treat . This study is registered with Clinical Trials.gov , number NCT00038727 . FINDINGS During the 10.0-year ( IQR 9.0 - 10.5 ) follow-up since r and omisation to DPP , the original lifestyle group lost , then partly regained weight . The modest weight loss with metformin was maintained . Diabetes incidence rates during the DPP were 4.8 cases per 100 person-years ( 95 % CI 4.1 - 5.7 ) in the intensive lifestyle intervention group , 7.8 ( 6.8 - 8.8 ) in the metformin group , and 11.0 ( 9.8 - 12.3 ) in the placebo group . Diabetes incidence rates in this follow-up study were similar between treatment groups : 5.9 per 100 person-years ( 5.1 - 6.8 ) for lifestyle , 4.9 ( 4.2 - 5.7 ) for metformin , and 5.6 ( 4.8 - 6.5 ) for placebo . Diabetes incidence in the 10 years since DPP r and omisation was reduced by 34 % ( 24 - 42 ) in the lifestyle group and 18 % ( 7 - 28 ) in the metformin group compared with placebo . INTERPRETATION During follow-up after DPP , incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group , but the cumulative incidence of diabetes remained lowest in the lifestyle group . Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years 
    Output:
    