Effects of a Multicomponent Lifestyle Intervention on Behavioral and Cardiometabolic Outcomes in Adults with Type 2 Diabetes Mellitus in the Peruvian Amazon

Abstract

Introduction: Lifestyle interventions are a fundamental component of type 2 diabetes mellitus management; however, evidence from real-world clinical settings regarding multicomponent interventions that simultaneously evaluate behavioral, metabolic, and anthropometric outcomes remains limited. Objective: To evaluate the effect of a multicomponent lifestyle intervention program on dietary habits, biochemical parameters, physical activity, and anthropometric indicators in adults with type 2 diabetes mellitus in the Peruvian Amazon. Methods: A quasi-experimental study with a non-randomized control group and pre–post assessments was conducted among 144 adults with type 2 diabetes mellitus (72 in the intervention group and 72 in the control group) receiving care at a hospital in the Peruvian Amazon. The three-month intervention included nutrition education sessions, practical workshops, group-based physical activity sessions involving traditional dance and Zumba, home visits, and follow-up through telephone calls and WhatsApp. Dietary habits, fasting blood glucose (FBG), glycated hemoglobin (HbA1c), lipid profile, physical activity (PA), body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were assessed. Intervention effects were estimated using linear mixed-effects regression models adjusted for age, sex, and disease duration. Results: Compared with the control group, participants receiving the intervention experienced greater improvements in dietary habits (β = 17.85; 95% CI: 16.80 to 18.89; p < 0.001), together with greater reductions in FBG (β = −84.23 mg/dL; 95% CI: −100.45 to −68.01; p < 0.001) and HbA1c (β = −2.32 percentage points; 95% CI: −2.74 to −1.90; p < 0.001). Greater reductions were also observed in triglycerides (β = −53.68 mg/dL), total cholesterol (β = −31.73 mg/dL), BMI (β = −1.67 kg/m2), WC (β = −5.31 cm), and WHtR (β = −0.034) (all p < file0.001). PA increased to a greater extent among participants receiving the intervention (β = 3015.40 MET-min/week; 95% CI: 2769.81 to 3260.99; p < 0.001), whereas no significant between-group difference in change was observed for serum creatinine (p = 0.075). Conclusions: Participation in a three-month multicomponent lifestyle intervention was associated with greater improvements in dietary habits, physical activity, glycemic control, lipid profile, and anthropometric indicators compared with usual care among adults with type 2 diabetes mellitus in the Peruvian Amazon.