Health Program Benefited Patients With Prediabetes

Nurse-managed protocols improved outpatient care in chronic illnesses
Nurse-managed protocols improved outpatient care in chronic illnesses
Nearly half of patients with prediabetes enrolled in a comprehensive health program plus usual care had normal blood glucose by 6 months.

Nearly half of the patients with prediabetes who enrolled in a comprehensive health program in addition to usual care had normal blood glucose levels by 6 months, according to new data presented at the American College of Cardiology (ACC) Scientific Sessions 2015.

“Many more patients reverted to normal blood glucose than expected, especially if we consider that they were not necessarily losing weight,” lead study author Mariam Kashani, DNP, MS, said in a press release. “This is important because prediabetes is a modifiable risk factor for cardiovascular disease [CVD].”

The aim of the observational study was to assess the effect of a multicomponent intervention on the CVD risk profile of patients with prediabetes without focusing on weight loss.

In all, Kashani, of Walter Reed National Military Medical Center in Bethesda, Maryland, and colleagues enrolled 508 consecutive patients (56% women; mean age, 53 years) from the Integrative Cardiac Health Project, a 12-month CVD risk reduction program that focuses on nutrition, exercise, stress and sleep improvement.

According to the release, the program includes a cardiovascular (CV) health assessment and personalized health recommendations tailored to national preventive care guidelines. This is followed by 14 personalized in-person or telephone coaching sessions with specialists in nutrition, exercise, sleep and stress management.

Patients completed questionnaires and were defined as either prediabetic (glucose ≥100 mg/dL and <140 mg/dL) or reverting prediabetes (glucose <100 mg/dL). Researchers excluded patients with diabetes.

Overall, 21% of patients had prediabetes, with a mean HbA1c of 5.9% and mean glucose of 108.1 mg/dL.

At 6 months, 49% of patients reverted to normal glucose values, irrespective of weight loss.

Furthermore, Kashani and colleagues reported that patients who regained normal glucose metabolism reduced their fasting glucose by a mean of 13 mg (12%).

“This is a big deal because we know that with each 5 mg/dL drop in blood glucose, there is a significant reduction in cardiovascular risk,” Kashani said. “Most importantly, they lowered their glucose levels below the threshold of 100 mg/dL when blood vessels start to become unhealthy.”

Looking ahead, Kashani said she and colleagues will be using the program’s registry to examine the sustainability of lifestyle change strategies over time and will initiate randomized controlled trials to develop more precise CV risk assessment tools.


  1. Kashani M et al. Abstract 1140-116. Presented at: American College of Cardiology (ACC) 64th Annual Scientific Session & Expo; March 14-16, 2015; San Diego.