Last updated August 24, 2026
Key finding
HbA1c was significantly lower at follow-up in Lifestyle Africa compared to the usual care group (mean difference = −0.24, p = 0.001).
This study evaluated the effectiveness of the Lifestyle Africa diabetes prevention program in low-resource settings. It found no significant difference in weight loss compared to usual care, but a notable reduction in HbA1c levels.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Long-Term (1–5 y)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study evaluated the effectiveness of the Lifestyle Africa diabetes prevention program in low-resource settings. It found no significant difference in weight loss compared to usual care, but a notable reduction in HbA1c levels.
Improving diabetes prevention strategies in low-resource settings is crucial, as these populations often face higher risks of diabetes and related complications. The significant reduction in HbA1c levels among participants in the Lifestyle Africa program suggests that tailored interventions can enhance glycemic control, potentially reducing the long-term burden of diabetes. However, the lack of significant weight loss highlights the need for comprehensive approaches that address multiple health factors.
The study's sample size may limit the generalizability of the findings. The focus on short-term outcomes may not capture long-term effects. Potential confounding factors were not fully accounted for.
Published in
Publication details and source links for this paper.
Delwyn C, Thandi P, Lungiswa T, et al. Efficacy of Lifestyle Africa, an Adapted Diabetes Prevention Program for Low-Resource Settings: A Cluster Randomized Controlled Trial. PLOS Medicine. 2022;19(4):e1003964. doi:10.1371/journal.pmed.1003964
Lifestyle Africa participants had a mean HbA1c reduction of -0.24 compared to usual care (p = 0.001).
Weight loss was -0.61% in Lifestyle Africa and -0.44% in usual care, with no significant difference (p = 0.71).
No significant changes were observed in systolic blood pressure (-1.36 mmHg, p = 0.63) or diastolic blood pressure (-0.39 mmHg, p = 0.78).
Evidence network
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This study contributes evidence to Lifestyle intervention for prediabetes and Diastolic blood pressure, HbA1c, Percentage weight loss after 12 weeks, and 3 more.
This study contributes evidence to
Primary intervention
Lifestyle intervention for prediabetes
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
6
Evidence pairs
938
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Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Related evidence
Evidence topic
Save evidence
Core evidence
The primary outcomes reported in this study.
Lifestyle intervention for prediabetes → Diastolic blood pressure
Lifestyle intervention for prediabetes → Diastolic blood pressure
Lifestyle intervention for prediabetes → Percentage weight loss after 12 weeks
Lifestyle intervention for prediabetes → Percentage weight loss after 12 weeks
Lifestyle intervention for prediabetes → Systolic blood pressure
Lifestyle intervention for prediabetes → Systolic blood pressure
Lifestyle intervention for prediabetes → Triglycerides
Lifestyle intervention for prediabetes → Triglycerides
Lifestyle intervention for prediabetes → Very-low-density lipoprotein cholesterol
Lifestyle intervention for prediabetes → Very-low-density lipoprotein cholesterol
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Lifestyle intervention for prediabetes and HbA1c, Lifestyle intervention for prediabetes and Blood Pressure.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
All studies on Lifestyle intervention for prediabetes
Contributes to Lifestyle intervention for prediabetes evidence base.
All studies measuring Blood Pressure
Measures Blood Pressure as a key outcome.
All studies measuring Weight Loss Outcomes
Measures Weight Loss Outcomes as a key outcome.
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13 results
5 results
13 results
13 results
5 results
Generated from the study's connected evidence using Evidence Intelligence™.
Lifestyle intervention for prediabetes may lower HbA1c.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
HbA1c
EvidenceScore™ Strong | EvidenceScore™ 84.9 | moderate positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Lifestyle intervention for prediabetes may improve diastolic blood pressure.
ConsistencyScore™: Results are generally consistent across studies.
Ranked evidence signals
Diastolic blood pressure
EvidenceScore™ Strong | EvidenceScore™ 82.8 | moderate positive | ConsistencyScore™ Generally Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Lifestyle intervention for prediabetes may improve systolic blood pressure.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Systolic blood pressure
EvidenceScore™ Strong | EvidenceScore™ 79.0 | weak positive | ConsistencyScore™ Consistent | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Lifestyle intervention for prediabetes for triglycerides.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Triglycerides
EvidenceScore™ Strong | EvidenceScore™ 79.0 | neutral | ConsistencyScore™ Mixed | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
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