Introduction
Diabetes, diabetes
DIABETES, TYPE 2 DIABETES, DIABETES
Based on recent estimates, there are 537 million people with diabetes globally with 433 million (80.6%) living in low and middle-income countries such as India [India has the second highest number of people with diabetes (74.2 million), accounting for 1 in 7 of all adults living with diabetes worldwide, and this is expected to increase to 124.9 million by 2045. About 57% of the estimated number of people with diabetes in India are undiagnosed [The efficacy, effectiveness, and implementation of lifestyle interventions aimed at preventing the onset of type 2 diabetes have been well-established at least in high-income countries. A review of 38 implementation trials has demonstrated a reduction in type 2 diabetes incidence of between 40–60% [In this study protocol paper, we briefly discuss the findings of a community-based diabetes prevention program conducted in the Indian state of Kerala, the Kerala Diabetes Prevention Program (K-DPP), from 2013–2016. We also present the rationale to conduct a nine-year follow-up of the original K-DPP participants; the aims, measures to be undertaken, and the analysis plan.