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Family-based intervention to improve healthy lifestyle and prevent Type 2 Diabetes amongst South Asians with central obesity and prediabetes

Objective

South Asians, who represent one-quarter of the world’s population, are at high risk of type-2 diabetes (T2D). Intensive lifestyle modification (healthy diet and physical activity) is effective at preventing T2D amongst South Asians with impaired glucose tolerance, but this approach is limited by high-cost, poor scalability and low impact on T2D burden.
We will complete a cluster-randomised clinical trial at 120 locations across India, Pakistan, Sri Lanka and the UK. We will compare family-based intensive lifestyle modification (22 health promotion sessions from a community health worker, active group, N=60 sites) vs usual care (1 session, control group, N=60 sites) for prevention of T2D, amongst 3,600 non-diabetic South Asian men and women with central obesity (waist≥100cm) and/or prediabetes (HbA1c≥6.0%). Participants will be followed annually for 3 years. The primary endpoint will be new-onset T2D (physician diagnosis on treatment or HbA1c≥6.0%, predicted N~734 over 3 years). Secondary endpoints will include waist and weight in the index case and family members. Our study has 80% power to identify a reduction in T2D risk with family-based intervention vs usual care of: 30% in South Asians with central obesity; 24% in South Asians with prediabetes; and 24% overall. Health economic evaluation will determine cost-effectiveness of family based lifestyle modification for prevention of T2D amongst South Asians with central obesity and / or prediabetes. The impact of gender and socio-economic factors on clinical utility and cost-effectiveness will be investigated.
Our results will determine whether screening by waist circumference and/or HbA1c, coupled with intervention by family-based lifestyle modification, is an efficient, effective and equitable strategy for prevention of T2D in South Asians. Our findings will thereby provide a robust evidence base for scalable community-wide approaches to reverse the epidemic of T2D amongst the >1.5 billion South Asians worldwide.

Call for proposal

H2020-HCO-2014-2015

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Sub call

H2020-HCO-2014

Coordinator

IMPERIAL COLLEGE OF SCIENCE TECHNOLOGY AND MEDICINE
Net EU contribution
€ 1 386 972,50
Address
South Kensington Campus Exhibition Road
SW7 2AZ London
United Kingdom

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Region
London Inner London — West Westminster
Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00

Participants (10)

DEVKI DEVI FOUNDATION SOCIETY
India
Net EU contribution
€ 247 050,00
Other funding
€ 0,00
UNIVERSITY OF COLOMBO
Sri Lanka
Net EU contribution
€ 155 550,00
Address
94 Cumaratunga Munidasa Mawatha
00300 Colombo Western Province

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Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00
UNIVERSITY OF KELANIYA
Sri Lanka
Net EU contribution
€ 121 237,50
Other funding
€ 0,00
UNIVERSITY OF SURREY
United Kingdom
Net EU contribution
€ 244 233,75
Address
Stag Hill
GU2 7XH Guildford

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Region
South East (England) Surrey, East and West Sussex West Surrey
Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00
LONDON NORTH WEST HEALTHCARE NATIONAL HEALTH SERVICE TRUST
United Kingdom
Net EU contribution
€ 749 537,50
Address
Watford Road
HA1 3UJ Harrow Middlesex

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Region
London Outer London — West and North West Brent
Activity type
Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)
Other funding
€ 0,00
INSTITUTE FOR HEALTH POLICY
Sri Lanka
Net EU contribution
€ 105 750,00
Other funding
€ 0,00
ACADEMISCH MEDISCH CENTRUM BIJ DE UNIVERSITEIT VAN AMSTERDAM
Netherlands
Net EU contribution
€ 146 250,00
Address
Meibergdreef 15
1105AZ Amsterdam

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Region
West-Nederland Noord-Holland Groot-Amsterdam
Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00
OULUN YLIOPISTO
Finland
Net EU contribution
€ 166 990,00
Address
Pentti Kaiteran Katu 1
90014 Oulu

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Region
Manner-Suomi Pohjois- ja Itä-Suomi Pohjois-Pohjanmaa
Activity type
Higher or Secondary Education Establishments
Other funding
€ 0,00
PUNJAB INSTITUTE OF CARDIOLOGY (PIC) LAHORE
Pakistan
Net EU contribution
€ 113 612,50
Address
Jail Road Ghous Ul Azam
54000 Lahore Punjab

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Activity type
Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)
Other funding
€ 0,00
SERVICES INSTITUTE OF MEDICAL SCIENCES
Pakistan
Net EU contribution
€ 176 900,00
Address
Jail Road Opposite Race Course Park
54000 Lahore

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Activity type
Public bodies (excluding Research Organisations and Secondary or Higher Education Establishments)
Other funding
€ 0,00