November 07, 2024 Research-backed program making big strides in preventing type 2 diabetes

By 2018, Lois Hourston of Kelowna, B.C., had been living with good intentions for more than 10 years. Lois kept putting her health on the back burner, telling herself she’d get around to making positive changes soon. But her wake-up call came when her doctor told her she had surpassed the 200-pound mark and diagnosed her with prediabetes.

Almost six million Canadians are at risk of developing diabetes, which refers to blood glucose (sugar) levels that are higher than normal and which elevate the risk of developing type 2 diabetes. As many as 40% of people with prediabetes progress to type 2 diabetes within five years. 

Behaviours change research for people with prediabetes

At the time of her diagnosis, Lois’s doctor’s office informed her about Small Steps for Big Changes, a pilot research project by Dr. Mary Jung, professor in the School of Health and Exercise Sciences at the University of British Columbia.

Dr. Jung and her team designed Small Steps for Big Changes based on evidence from close to a decade of clinical trials on behaviour change. Their approach helps people living with prediabetes to make lasting dietary and exercise changes to lower their risk of developing type 2 diabetes. Delivered in fitness facilities such as YMCA Canada, the program includes six one-on-one counselling sessions with a trained coach, a complimentary one-month membership at a local fitness facility, and ongoing follow-up appointments to discuss diet, exercise, and blood sugar management.

The counselling sessions were eye-opening for me as I began taking a hard look at my health,” says Lois. “They equipped me with knowledge I didn’t know I lacked about healthy eating and exercise. The support I received was excellent and included personal workout sessions, regular body measurements, and endless inspiration from trainers, program counsellors, doctors, and instructors.

During her time in the program, Lois picked up healthy eating tips and tricks and started naturally incorporating physical activity into her routine. She began to lose a pound of weight a week, eventually totalling 40 pounds over 10 months. She also formed supportive new friendships—and a walking and hiking group—with fellow program participants.

Expanding the program expansion with research funding

When Lois entered Small Steps for Big Changes, it was still a pilot project, but it grew when Dr. Jung’s team received $270,000 in funding from Diabetes Canada’s End Diabetes 100 Award in 2021. The funding allowed the researchers to expand into five northern rural communities in British Columbia with high rates of type 2 diabetes and limited access to healthcare providers and diabetes prevention programs. The increased number of sites helped the research team to evaluate the program's implementation and effectiveness and develop a template for further expansion across Canada.

Dr. Jung’s explains her motivation to improve access to care: “Despite universal healthcare in Canada, rates of type 2 diabetes and access to diabetes preventative care are both affected by racial, sex- and gender-based health inequities. My family, like many families who immigrated to Canada, has experienced this. I am personally committed to ensuring that all Canadians who are at risk of type 2 have access to effective, unbiased care that is delivered without discrimination.”

Successfully preventing the progression to type 2 diabetes

In 2023, the Diabetes Canada funding was leveraged to obtain $7.5 million from the Canadian Institutes of Health Research, Public Health Agency of Canada, and the National Health Medical Research Council of Australia for further expansion. To date, more than 550 participants have completed the Small Steps for Big Changes program with a 100% success rate: at 12 months' follow-up, none of the participants had been diagnosed with type 2 diabetes, and 85% of them, including Lois, had reduced their blood sugar levels to below the prediabetes range.

“Every three minutes, someone in Canada is diagnosed with diabetes, which is an alarming statistic that demands urgent action,” says Dr. Rachel Reeve, executive director of research and science, Diabetes Canada. That’s why we invest in new knowledge and solutions through research programs such as Small Steps for Big Changes, which benefit people with or at high risk of developing diabetes across Canada.”

Today, Small Steps for Big Changes operates in 17 sites across seven provinces. By the end of 2025, the program will expand its track record of success to more than 40 YMCA locations across Canada, with additional locations in Portugal and Australia. For Lois, healthy eating is now a habit and physical activity is routine. She has maintained her weight loss and still meets with her walking and hiking group every Sunday.

“I have reclaimed my health, firmly embraced my new active retirement lifestyle, and formed new friendships here in Kelowna,” says Lois. “My husband says this program has saved my life, and that might be true. I am so thrilled for people coming into it because they are going to be okay and get their health back.”

Learn more about this and other groundbreaking research projects funded by Diabetes Canada, and donate today to help improve the lives of people affected by diabetes.