Researchers hypothesized that US adults with prediabetes and normal BMI develop diabetes through different pathophysiological mechanisms than those with high BMIs and that, therefore, methods of prevention may differ in the absence of overweight/obesity.  They compared the effect of technology-enabled lifestyle health coaching (LHC) on fasting plasma glucose (FPG) in normal weight, overweight, and obese adults with prediabetes who completed a baseline and follow-up evaluation as part of an LHC program. The program included one-on-one behaviorally oriented coaching, predominately via the telephone and Internet, on exercise, nutrition, and weight management. The study team observed that BMI decreased significantly in overweight and obese participants but was unchanged in normal-weight participants. In contrast, weekly aerobic exercise increased and FPG decreased significantly in all three groups. FPG was reduced to less than 100 mg/dl in 62.4%, 51.7%, and 43.6% of the normal weight, overweight, and obese participants, respectively. The researchers concluded that LHC is at least as effective in managing fasting plasma glucose (FPG) in normal weight adults with prediabetes as it is in overweight/obese adults with prediabetes.

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