Modification of the diabetes prevention program for the treatment of nonalcoholic fatty liver disease: A pilot study

OBJECTIVE: The Diabetes Prevention Program (DPP) is the gold standard lifestyle modification program that reduces incident type 2 diabetes mellitus. Patients with prediabetes and patients with non‐alcoholic fatty liver disease (NAFLD) often share metabolic features; we hypothesized that the DPP could be adapted and used to improve outcomes in patients with NAFLD. METHODS: NAFLD patients were recruited into a 1 year modified DPP. Demographics, medical comorbidities, and clinical laboratory values were collected at baseline, 6 and 12 months. The primary endpoint was change in weight at 12 months. Secondary endpoints were changes in hepatic steatosis, metabolic comorbidities, and liver enzymes (per‐protocol basis) and retention at 6 and 12 months. RESULTS: Fourteen NAFLD patients enrolled; three dropped out before 6 months. From baseline to 12 months, hepatic steatosis (p = 0.03), alanine aminotransferase (p = 0.02), aspartate aminotransferase (p = 0.02), high‐density lipoprotein (p = 0.01) and NAFLD fibrosis score (p < 0.001) improved, but low‐density lipoprotein worsened (p = 0.04). CONCLUSION: Seventy‐nine percent of patients completed the modified DPP. Patients lost weight and had improvements in five out of six indicators of liver injury and lipid metabolism. CLINICAL TRIAL REGISTRY NUMBER: NCT04988204.