{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:11:56Z","timestamp":1781118716812,"version":"3.54.1"},"reference-count":31,"publisher":"American Diabetes Association","issue":"3","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institutes of Diabetes, Digestive, and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK125780"],"award-info":[{"award-number":["R01DK125780"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Weight loss and physical activity (PA) reduce diabetes risk, but their independent contributions to A1C reduction in prediabetes are not fully quantified. This study examined the associations between weight loss, PA, and the odds of achieving A1C reduction thresholds during a lifestyle intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This secondary analysis used data from a randomized clinical trial. Participants (n = 209) included adults with prediabetes and overweight\/obesity who completed a 12-month follow-up. Weight loss was categorized as none (\u22640%), mild (&amp;gt;0\u20132.5%), moderate (&amp;gt;2.5\u20135%), and substantial (&amp;gt;5%). PA was objectively measured via actigraphy and grouped into six 75-min weekly increments (ranging from &amp;lt;75 to &amp;gt;375 min). Adjusted logistic regression models estimated odds of achieving A1C reductions (from \u22650.1% to \u22650.4%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A dose-dependent relationship was observed between weight loss and A1C reduction. Compared with no weight loss, substantial weight loss (&amp;gt;5%) was associated with increased odds of lowering A1C across all thresholds (\u22650.1% to \u22650.4%; odds ratio [OR] range 6.36\u20139.49, all P \u2264 0.001). Moderate weight loss (&amp;gt;2.5\u20135%) was associated with increased odds of lowering A1C by \u22650.1% to \u22650.3% (OR range 2.81\u20134.83, all P &amp;lt; 0.05), although this was not significant for the \u22650.4% threshold. In contrast, PA levels were not significantly associated with A1C reduction compared with the reference group (&amp;lt;75 min\/week) in adjusted models across any threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These findings support that weight loss may be the primary driver of improved glycemic control in individuals with prediabetes, underscoring the importance of prioritizing weight loss in lifestyle interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/doc25-0091","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:01:56Z","timestamp":1775484116000},"page":"358-365","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":0,"title":["Association of Weight Loss and Physical Activity With A1C Reduction in a Diabetes Prevention Program: A Secondary Analysis of a Randomized Clinical Trial"],"prefix":"10.2337","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7406-6077","authenticated-orcid":false,"given":"Devin M.","family":"Dishong","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Lalani","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zade","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliyah","family":"Shehadeh","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed S.","family":"Abusamaan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0210-655X","authenticated-orcid":false,"given":"Nestoras","family":"Mathioudakis","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine , Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"AI-DPP Study Group*","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nestoras N","family":"Mathioudakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Lalani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed S","family":"Abusamaan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Dobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeromie","family":"Ballreich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisa","family":"Maruthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McGready","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Riekert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Wanigatunga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliyah","family":"Shehadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Defne","family":"Alver","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ringham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatmata","family":"Vandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Zade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Marrero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Schiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ellie","family":"Alderfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nae-Yuh","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Benjamin-Neelon.","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"2026061014515446700_B1","doi-asserted-by":"crossref","first-page":"437","DOI":"10.7326\/M15-0452","article-title":"Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force","volume":"163","author":"Balk","year":"2015","journal-title":"Ann Intern Med"},{"key":"2026061014515446700_B2","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.2337\/dc22-2376","article-title":"Global prevalence of prediabetes","volume":"46","author":"Rooney","year":"2023","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B3","doi-asserted-by":"crossref","first-page":"543","DOI":"10.7326\/0003-4819-159-8-201310150-00007","article-title":"Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis","volume":"159","author":"Schellenberg","year":"2013","journal-title":"Ann Intern Med"},{"key":"2026061014515446700_B4","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1056\/NEJMoa012512","article-title":"Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin","volume":"346","author":"Diabetes Prevention Program Research Group","year":"2002","journal-title":"N Engl J Med"},{"key":"2026061014515446700_B5","doi-asserted-by":"crossref","first-page":"3230","DOI":"10.2337\/diacare.26.12.3230","article-title":"The Finnish Diabetes Prevention Study (DPS): lifestyle intervention and 3-year results on diet and physical activity","volume":"26","author":"Lindstr\u00f6m","year":"2003","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B6","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.2337\/diacare.25.12.2165","article-title":"The Diabetes Prevention Program (DPP): description of lifestyle intervention","volume":"25","author":"Diabetes Prevention Program (DPP) Research Group","year":"2002","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B7","doi-asserted-by":"crossref","first-page":"537","DOI":"10.2337\/diacare.20.4.537","article-title":"Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance: the Da Qing IGT and Diabetes Study","volume":"20","author":"Pan","year":"1997","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B8","doi-asserted-by":"crossref","first-page":"8493145","DOI":"10.1155\/2017\/8493145","article-title":"The effectiveness of lifestyle adaptation for the prevention of prediabetes in adults: a systematic review","volume":"2017","author":"Kerrison","year":"2017","journal-title":"J Diabetes Res"},{"key":"2026061014515446700_B9","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1007\/s00125-005-0097-z","article-title":"The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1)","volume":"49","author":"Ramachandran","year":"2006","journal-title":"Diabetologia"},{"key":"2026061014515446700_B10","doi-asserted-by":"crossref","first-page":"e151","DOI":"10.2337\/dci23-0036","article-title":"Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus","volume":"46","author":"Sacks","year":"2023","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B11","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1249\/MSS.0000000000001135","article-title":"Aerobic exercise training modalities and prediabetes risk reduction","volume":"49","author":"Rowan","year":"2017","journal-title":"Med Sci Sports Exerc"},{"key":"2026061014515446700_B12","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.2337\/dc10-2415","article-title":"Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes","volume":"34","author":"Wing","year":"2011","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B13","unstructured":"Centers for Disease Control and Prevention\n          . Diabetes Prevention Recognition Program Standards and Operating Procedures, 2024. Accessed 13 July 2025. Available from https:\/\/www.cdc.gov\/diabetes-prevention\/media\/pdfs\/legacy\/dprp-standards.pdf"},{"key":"2026061014515446700_B14","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1001\/jama.2025.19563","article-title":"An AI-powered lifestyle intervention vs human coaching in the Diabetes Prevention Program: a randomized clinical trial","volume":"334","author":"Mathioudakis","year":"2025","journal-title":"JAMA"},{"key":"2026061014515446700_B15","unstructured":"Centers for Disease Control and Prevention\n          . Lifestyle Coach Training Guide - Program Overview. Accessed 27 January 2026. Available from https:\/\/www.cdc.gov\/diabetes-prevention\/media\/pdfs\/Coach-Program_Overview.pdf"},{"key":"2026061014515446700_B16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1186\/s13063-024-08177-8","article-title":"Effectiveness of artificial intelligence vs. human coaching in diabetes prevention: a study protocol for a randomized controlled trial","volume":"25","author":"Abusamaan","year":"2024","journal-title":"Trials"},{"key":"2026061014515446700_B17","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1249\/MSS.0b013e31827f0d9c","article-title":"Estimating activity and sedentary behavior from an accelerometer on the hip or wrist","volume":"45","author":"Rosenberger","year":"2013","journal-title":"Med Sci Sports Exerc"},{"key":"2026061014515446700_B18","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1080\/02640414.2020.1794244","article-title":"Development of cut-points for determining activity intensity from a wrist-worn ActiGraph accelerometer in free-living adults","volume":"38","author":"Montoye","year":"2020","journal-title":"J Sports Sci"},{"key":"2026061014515446700_B19","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"2026061014515446700_B20","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2026061014515446700_B21","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.2337\/dc06-0560","article-title":"Effect of weight loss with lifestyle intervention on risk of diabetes","volume":"29","author":"Hamman","year":"2006","journal-title":"Diabetes Care"},{"key":"2026061014515446700_B22","doi-asserted-by":"crossref","first-page":"e1621","DOI":"10.1210\/clinem\/dgz189","article-title":"Weight loss improves \u03b2-cell function in people with severe obesity and impaired fasting glucose: a window of opportunity","volume":"105","author":"Rothberg","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2026061014515446700_B23","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/S2213-8587(23)00235-8","article-title":"Mechanisms of weight loss-induced remission in people with prediabetes: a post-hoc analysis of the randomised, controlled, multicentre Prediabetes Lifestyle Intervention Study (PLIS)","volume":"11","author":"Sandforth","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026061014515446700_B24","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1123\/jpah.2016-0632","article-title":"Effect of physical activity intervention in prediabetes: a systematic review with meta-analysis","volume":"14","author":"Jadhav","year":"2017","journal-title":"J Phys Act Health"},{"key":"2026061014515446700_B25","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s00592-017-1037-3","article-title":"Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials","volume":"54","author":"Boniol","year":"2017","journal-title":"Acta Diabetol"},{"key":"2026061014515446700_B26","doi-asserted-by":"crossref","first-page":"1227489","DOI":"10.3389\/fendo.2023.1227489","article-title":"Effects of aerobic exercises in prediabetes patients: a systematic review and meta-analysis","volume":"14","author":"Wang","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026061014515446700_B27","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/j.amepre.2015.03.007","article-title":"Awareness of prediabetes and engagement in diabetes risk-reducing behaviors","volume":"49","author":"Gopalan","year":"2015","journal-title":"Am J Prev Med"},{"key":"2026061014515446700_B28","doi-asserted-by":"crossref","first-page":"e13251","DOI":"10.1111\/obr.13251","article-title":"Effect of exercise training interventions on energy intake and appetite control in adults with overweight or obesity: a systematic review and meta-analysis","volume":"22","author":"Beaulieu","year":"2021","journal-title":"Obes Rev"},{"key":"2026061014515446700_B29","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.ajcnut.2024.08.031","article-title":"Efficacy of lifestyle weight loss interventions on regression to normoglycemia and progression to type 2 diabetes in individuals with prediabetes: a systematic review and pairwise and dose-response meta-analyses","volume":"120","author":"Jayedi","year":"2024","journal-title":"Am J Clin Nutr"},{"key":"2026061014515446700_B30","doi-asserted-by":"crossref","first-page":"3330","DOI":"10.1038\/s41591-025-03944-9","article-title":"Prevention of type 2 diabetes through prediabetes remission without weight loss","volume":"31","author":"Sandforth","year":"2025","journal-title":"Nat Med"},{"key":"2026061014515446700_B31","doi-asserted-by":"crossref","first-page":"1562108","DOI":"10.3389\/fcdhc.2025.1562108","article-title":"Consumer-oriented review of digital diabetes prevention programs: insights from the CDC\u2019s diabetes prevention recognition program","volume":"6","author":"Lalani","year":"2025","journal-title":"Front Clin Diabetes Healthc"}],"container-title":["Diabetes Obesity and Cardiometabolic CARE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article-pdf\/1\/3\/358\/861121\/docm250091.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article-pdf\/1\/3\/358\/861121\/docm250091.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:52:03Z","timestamp":1781117523000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/docm-care\/article\/1\/3\/358\/164682\/Association-of-Weight-Loss-and-Physical-Activity"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,4,6]]},"published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.2337\/doc25-0091","relation":{},"ISSN":["3067-3518","3067-3534"],"issn-type":[{"value":"3067-3518","type":"print"},{"value":"3067-3534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]}}}