Intensive Lifestyle Intervention for Type 2 Diabetics: The KP TLC Pilot

Peer reviewed research studies have proven the benefits of lifestyle interventions including
the reversal of coronary artery disease and of diabetes. Experts agree that such a lifestyle
must include a diet rich in whole, grown foods while low in saturated fat and cholesterol;
regular physical activity; and healthy ways to cope with stress.

There are several challenges with implementing such lifestyle interventions such as
educating the general public and health care providers to the components of this lifestyle
and in getting people to adopt these healthy lifestyle changes.

While retreat-style, intensive lifestyle programs have shown that these obstacles can be
overcome, they require monetary and time investments generally not feasible for the general
public.

A community-based, lifestyle program such as 'The Coronary Health Improvement Project'
program offers similar potential benefits at a more reasonable cost. It does so through an
intensive education (32 hours total) taught over 4 weeks, followed by an 8-week
consolidation period which include live or DVD based group sessions, discussions led by a
program facilitator, and medical monitoring.

Kaiser Permanente, the leading Health maintenance organization in the nation, places special
focus and significant resources into preventive medicine and health promotion, providing
services to thousands of plan members but none with the level of intensity of 'The Coronary
Health Improvement Project'.

This study aims to determine if 'The Coronary Health Improvement Project' program can
significantly improve blood sugar control in kaiser plan members with uncontrolled
diabetes.

Inclusion Criteria:

- English-speaking patients > 18 years of age, with at least 6 months of membership,
who have type 2 diabetes.

- Patients must have a recent HbA1C lab value > 8.0, and have had at least 2 previous
HbA1C measures during the previous 6-12 months.

- Patients with HbA1C values that are consistently > 8.0 over the previous 6-12 months
will be invited to participate.

Exclusion Criteria:

1. current excessive alcohol use (drinking > 14 alcohol beverages per week for men or >
7 per week for women or > 4 per day for men or > 2 per day for women on 2 or more
occasions each month)

2. current use of illegal or street drugs,

3. severely decreased functional capacity (shortness of breath or chest pain at rest or
with minimal activity), and/or

4. suicidal thoughts or depression, will

5. Patients with severely limited physical ability