Lectures and seminars KI Lifestyle4Health network seminar #6: The DMagic trial

Due to the already high, and increasing burden of type 2 diabetes (T2DM), cost-effective and sustainable approaches to prevention are needed which can be delivered at scale in low and middle-income settings. The DMagic trial aimed to assess two interventions that could meet this criteria – an mHealth intervention, and a Participatory Learning and Action (PLA) cycle in rural Bangladesh. We conducted a three-arm, cluster-randomised trial in a population of 125 000 people in Faridpur district between 2016-2018. We found a large reduction in the combined prevalence of type 2 diabetes and intermediate hyperglycaemia in the PLA group compared with the control group (aOR: 0·36, 0·27–0·48). However, we found no significant differences in secondary outcomes of obesity, hypertension, exercise and diet behaviour, and there was no evidence of effect in the mHealth arm. To explore whether the PLA intervention can be implemented at scale, and maintain similar levels of effect, we are now replicating this intervention in a population of 230,000 in a new setting in rural Bangladesh – the DClare trial.

About the speaker

Dr. King is an Associate Professor in Global Health, with a focus on infectious epidemiology. Her research has mostly centered around paediatric pneumonia diagnostics and case management in sub-Saharan Africa – and methodologically on conducting community based cluster randomised trials and observational research. One of her current projects is coordinating a cluster RCT in rural Bangladesh which tests a Participatory Learning and Action cycle intervention to prevent and improve management of type 2 diabetes.  She completed her PhD in 2012 from Imperial college in surveillance of healthcare associated infections.