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BMC Public Health. 2012; 12: 371.
Published online May 23, 2012. doi:  10.1186/1471-2458-12-371
PMCID: PMC3504520
Feasibility and effectiveness of a targeted diabetes prevention program for 18 to 60-year-old South Asian migrants: design and methods of the DH!AAN study
Everlina MA Vlaar,corresponding author1 Irene GM van Valkengoed,1 Vera Nierkens,1 Mary Nicolaou,1 Barend JC Middelkoop,2,3 and Karien Stronks1
1Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
2Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
3Public Health Service, The Hague, The Netherlands
corresponding authorCorresponding author.
Everlina MA Vlaar: E.M.Vlaar/at/amc.uva.nl; Irene GM van Valkengoed: I.G.vanValkengoed/at/amc.uva.nl; Vera Nierkens: V.Nierkens/at/amc.uva.nl; Mary Nicolaou: M.Nicolaou/at/amc.uva.nl; Barend JC Middelkoop: B.Middelkoop/at/lumc.nl; Karien Stronks: K.Stronks/at/amc.uva.nl
Received March 22, 2012; Accepted April 2, 2012.
Abstract
Background
South Asian migrants are at particularly high risk of type 2 diabetes. Previous studies have shown that intensive lifestyle interventions may prevent the onset of diabetes. Such interventions have not been culturally adapted and evaluated among South Asians in industrialized countries. Therefore, we have set up a randomized controlled trial to study the effectiveness of a targeted lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old Hindustani Surinamese (South Asians) in The Hague, the Netherlands. Here we present the study design and describe the characteristics of those recruited.
Methods
Between May 18, 2009 and October 11, 2010, we screened 2307 Hindustani Surinamese (18–60 years old) living in The Hague. We sent invitations to participate to those who had an impaired fasting glucose of 5.6-6.9 mmol/l, an impaired glucose tolerance of 7.8-11.0 mmol/L, a glycated hemoglobin level of 6.0% or more and/or a value of 2.39 or more for the homeostasis model assessment of estimated insulin resistance. In total, 536 people (56.1% of those eligible) participated. People with a higher level of education and a family history of type 2 diabetes were more likely to participate. The control and intervention groups were similar with regard to important background characteristics. The intervention group will receive a culturally targeted intervention consisting of dietary counseling using motivational interviewing and a supervised physical activity program. The control group will receive generic lifestyle advice. To determine the effectiveness, a physical examination (anthropometrics, cardiorespiratory test, lipid profile, and measures of oral glucose tolerance, glycated hemoglobin, and insulin) and interview (physical activity, diet, quality of life, and intermediate outcomes) were carried out at baseline and will be repeated at 1 year and 2 years. The process and the costs will be evaluated.
Discussion
This trial will provide insight into the feasibility and effectiveness of a targeted, intensive, lifestyle intervention for the risk of type 2 diabetes and cardiovascular risk factors among 18 to 60-year-old South Asians.
Trial registration
Dutch Trial Register: NTR1499
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