Effective preventive care programs are urgently needed during humanitarian crises, as has been especially obvious during the COVID-19 pandemic. A pragmatic trial was designed: hybridized intervention (Diabetes Prevention Program [DPP] + medical nutrition therapy + liquid diet [LD]; LD group) vs. DPP only (DPP group). The participants were adults who were overweight/obese and at high risk of type 2 diabetes mellitus (T2DM). The LD consisted of a “homemade” milk- and fruit-juice-based beverage. Pandemic restrictions delayed the program by nine months, tripled the amount of time required for screening, and reduced the total sample to 60%. Eventually, 127 participants were randomized, and 94/127 participants (74.0%) completed the first phase. Participant dropout was influenced by migration, COVID-19 symptoms, education level, and socioeconomic status. In two months, the LD group lost 2.9 kg (p < 0.001) and the DPP group, 2.2 kg (p < 0.001) (between-group p = 0.170), with improvements in their cardiometabolic risk factors. At this stage, the DPP was shown to be feasible and effective, demonstrating weight loss with the improvement of cardiometabolic risk factors in a primary setting in Venezuela, a middle-income country with a chronic humanitarian crisis, during the COVID-19 pandemic.

Departments of Global Health and Population and Epidemiology Harvard T H Chan School of Public Health Harvard University Boston MA 02115 USA

Division of Endocrinology Diabetes and Bone Icahn School of Medicine at Mount Sinai New York NY 10028 USA

Foundation for Clinic Public Health and Epidemiological Research of Venezuela Barquisimeto 3001 Venezuela

International Clinical Research Center Brno Pekařská 53 656 91 Brno Czech Republic

The Marie Josée and Henry R Kravis Center for Cardiovascular Health at Mount Sinai Heart Icahn School of Medicine at Mount Sinai New York NY 10028 USA

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