OBJECTIVE To assess participant-level results from the first 4 years of implementation of the National Diabetes Prevention Program (National DPP), a national effort to prevent type 2 diabetes in those at risk through structured lifestyle change programs.

RESEARCH DESIGN AND METHODS Descriptive analysis was performed on data from 14,747 adults enrolled in year-long type 2 diabetes prevention programs during the period February 2012 through January 2016. Data on attendance, weight, and physical activity minutes were summarized and predictors of weight loss were examined using a mixed linear model. All analyses were performed using SAS 9.3.

RESULTS Participants attended a median of 14 sessions over an average of 172 days in the program (median 134 days). Overall, 35.5% achieved the 5% weight loss goal (average weight loss 4.2%, median 3.1%). Participants reported a weekly average of 152 min of physical activity (median 128 min), with 41.8% meeting the physical activity goal of 150 min per week. For every additional session attended and every 30 min of activity reported, participants lost 0.3% of body weight (P < 0.0001).

CONCLUSIONS During the first 4 years, the National DPP has achieved widespread implementation of the lifestyle change program to prevent type 2 diabetes, with promising early results. Greater duration and intensity of session attendance resulted in a higher percent of body weight loss overall and for subgroups. Focusing on retention may reduce disparities and improve overall program results. Further program expansion and investigation is needed to continue lowering the burden of type 2 diabetes nationally.

目的评估国家糖尿病预防计划 (National DPP) 实施前 4 年参与者层面的结果，该计划是一项通过结构化的生活方式改变计划来预防高危人群患 2 型糖尿病的全国性努力。

研究设计和方法 对2012 年 2 月至 2016 年 1 月期间参加为期一年的 2 型糖尿病预防计划的 14,747 名成年人的数据进行了描述性分析。总结了出勤率、体重和体力活动分钟数的数据，并总结了体重减轻的预测因素使用混合线性模型进行检查。所有分析均使用 SAS 9.3 进行。

结果参与者在该计划的平均 172 天（中位数 134 天）内平均参加了 14 场课程。总体而言，35.5% 的人实现了 5% 的减重目标（平均减重 4.2%，中位数减重 3.1%）。参与者报告每周平均进行 152 分钟的体力活动（中位数为 128 分钟），其中 41.8% 的人达到了每周 150 分钟的体力活动目标。每参加一次额外的课程并报告每 30 分钟的活动，参与者的体重就会减轻 0.3% ( P < 0.0001)。

结论在最初 4 年里，国家民进党广泛实施了预防 2 型糖尿病的生活方式改变计划，并取得了可喜的早期成果。参加会议的持续时间和强度越长，整体和亚组的体重减轻百分比就越高。关注保留可以减少差异并改善整体计划结果。需要进一步扩大计划和进行调查，以继续降低全国 2 型糖尿病的负担。