Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial

Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial Aisa Abba Gana, Zainab Abdulkadir, Fatima Mohammed Damagum, Tiri Titilope Ogunyele, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8658846/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 13 You are reading this latest preprint version Abstract BACKGROUND Optimal glycaemic control is crucial in diabetic care as it minimizes complications. Adherence to a healthy lifestyle positively impacts diabetic care. This study aimed to investigate the effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control. METHODS The study was a randomised controlled trial (RCT) conducted among Type-2 Diabetes Mellitus (T2DM) patients over 22 weeks from November 2023 to April 2024. Participants were randomly assigned to either intervention or control arms by block randomization in blocks of four using a table of random numbers at a 1:1 ratio, with 63 participants in each arm. Data were collected using an adapted WHO STEPS questionnaire on sociodemographic, clinical characteristics and lifestyle practices both pre- and post-intervention. A composite Health Behaviour Score (HBS) was used for scoring. Structured counselling was conducted using the 5A’s framework, with five follow-up telephone reminders containing standard pre-recorded messages in Hausa (predominant language) and English. RESULTS The study found a significant post‑intervention increase in healthy behaviour scores; intervention (73.8%) compared to control (26.2%). The difference was statistically significant (χ² = 29.3, p < 0.001), while both arms had pre-intervention comparable baseline healthy behaviour scores (χ² = 0.145, p = 0.703). The Wilcoxon signed-rank test indicated a statistically significant decrease in median HbA1c post-intervention in both arms (intervention: z = -3.774, p < 0.001; control: z = -3.158, p = 0.002). However, the effect of counselling on glycaemic control was not statistically significant (𝛘 2 = 3.517 p = 0.061). CONCLUSION Structured lifestyle modification counselling significantly improved healthy behaviour among T2DM patients with no significant effect on glycaemic control. This suggests that counselling is effective for lifestyle change. Therefore, integrating structured lifestyle counselling with telephone reminders may serve as an innovative way to promote healthy lifestyles in the busy resource-limited primary care setting. TRIAL REGISTRATION The trial was registered by Pan African Clinical Trial Registry (https//pactr.samrc.ac.za) with registration number PACTR202601577207835 registered on 20th January, 2026. Counselling type-2 DM glycaemic control lifestyle practices primary care Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 INTRODUCTION Diabetes Mellitus (DM) is a major cause of increased morbidity and mortality as well as a decreased quality of life. 1 DM also accounts for 1.9% of the global disability-adjusted years (DALY). 1–4 According to the International Diabetes Federation Atlas 2021, there is progressive prevalence around the world that affected 537 million adults (20–79 years). The number is expected to rise to 643 million by 2030 and 783 million by 2045, with approximately 81% of those living with diabetes residing in low- and middle-income countries such as Nigeria. 2 , 3 According to the World Health Organization (WHO), Ethiopia, South Africa, the Democratic Republic of Congo, Nigeria, and Tanzania were the top five African nations in 2017 with a high number of persons with diabetes mellitus (18–99 years). 2 In Nigeria, Uloko et al reported that Type-2 Diabetes Mellitus (T2DM ) pooled prevalence in 2017 was highest in the south-south (9.8%) and lowest in the North-west (3.0%), posing a greater risk to the health system. 3 , 5 The risk factors associated with T2DM and its management are both modifiable and non-modifiable. The modifiable risk factors are mostly behavioural and lifestyle practices such as excess use of high-calorie diet, lack of exercise, excess alcohol intake and cigarette smoking. Hence, there is a need to promote a healthy lifestyle via structured lifestyle modification counselling. Early and intensive non-pharmacological intervention reduces the risk of microvascular and macrovascular complications and slows disease progression in T2DM. 6 Good glycaemic control may be achieved through lifestyle modification counselling and adherence to structured lifestyle intervention, which in turn decreases morbidity/mortality/disability. 7 In non-DM people, lifestyle modification helps to prevent T2DM or other cardiovascular risk factors. There is a dearth of information on the combined use of lifestyle modification counselling and telephone reminders to promote adherence to healthy lifestyle practices in a busy setting like ours. This is imperative, given the doctor-patient ratio in resource-limited settings which will not allow one-on-one lifestyle modification (LSM) counselling of T2DM at every visit due to resource constraints. Hence, the need for this study, which assessed the effect of structured LSM which combines one-on-one single counselling with subsequent telephone reminders of pre-recorded messages in a language patients are more familiar with. This may be an innovative way to promote a healthy lifestyle and optimize glycaemic control among T2DM patients attending primary care in resource-limited climes like ours. 8 METHODS Study population and design The study was a superiority parallel, 1:1 ratio randomised controlled trial conducted over a period of 22 weeks, among Type 2 diabetes mellitus patients aged 18 years and above who have been receiving the routine care for ≥ 6 months at the Family Medicine Clinic of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Those excluded were patients who had diabetic emergencies, pregnant women and patients with documented cognitive impairment. Sample size estimation The desired sample size was estimated using formula \(\:N=2\:\left[\frac{{\left({Z}_{\alpha\:}+\:{Z}_{\beta\:}\right)}^{2}}{{\left(\delta\:\right)}^{2}}\right]X\:\) S 2 for continuous variable. 9 , 10 Where, \(\:\text{N}\:\text{M}\text{i}\text{n}\text{i}\text{m}\text{u}\text{m}\:\text{s}\text{a}\text{m}\text{p}\text{l}\text{e}\:\text{s}\text{i}\text{z}\text{e}\:\text{f}\text{o}\text{r}\:\text{e}\text{a}\text{c}\text{h}\:\text{o}\text{f}\:\text{t}\text{h}\text{e}\:\text{s}\text{t}\text{u}\text{d}\text{y}\:\text{a}\text{r}\text{m}\) $$\:\text{Z}{\alpha\:}=\text{L}\text{e}\text{v}\text{e}\text{l}\:\text{o}\text{f}\:\text{s}\text{t}\text{a}\text{t}\text{i}\text{s}\text{t}\text{i}\text{c}\text{a}\text{l}\:\text{s}\text{i}\text{g}\text{n}\text{i}\text{f}\text{i}\text{c}\text{a}\text{n}\text{c}\text{e}\:\text{a}\text{t}\:95\text{\%}\:\text{c}\text{o}\text{n}\text{f}\text{i}\text{d}\text{e}\text{n}\text{c}\text{e}\:\text{l}\text{e}\text{v}\text{e}\text{l}=1.96$$ $$\:\text{Z}{\beta\:}\:=\text{D}\text{e}\text{s}\text{i}\text{r}\text{e}\text{d}\:\text{p}\text{o}\text{w}\text{e}\text{r}\:\text{o}\text{f}\:80\text{\%}\:\:=0.84$$ \(\:{\mu\:}_{1}=\) 7.9mmol/L, the mean fasting blood glucose (FBG) level from a previous study at AKTH. 11 S = Standard deviation = 2.8mmol/L. 11 \(\:\delta\:\) = Effect size, which was the hypothesized clinically significant difference detectable in the mean FBG levels (assuming a 20% reduction from 7.9mmol/L) = 1.58mmol/L N = 49.24 (Rounded up to 50 participants in each arm) N = N/ (1-r), where, r was the loss to follow-up rate. Therefore, the adjusted N = 50/0.8 = 63. Therefore, 63 participants were recruited per study arm, for a total of 126 participants. Study procedure Sampling method A systematic sampling technique was used and 126 participants selected over a period of six weeks, with a sampling interval where every 6th participant was selected. The first participant was selected by simple random sampling through ballot. Informed written consent was obtained from all the participants and confidentiality was ensured. Randomisation After initial recruitment for 6 weeks, participants were randomly divided into blocks of four at random (using a table of random numbers), with half of the participants in each block assigned to the intervention and the other half to the control arm. A trained and experienced research assistant with over seven years of involvement in similar hospital-based research facilitated the randomization process. Patients were recruited in blocks of four at a time such that there were six possible ways of allocating intervention with two patients allotted to group A and two patients allotted to group B per block. The six possible ways of allocating the blocks of size four include AABB, ABAB, ABBA, BBAA, BABA and BAAB. After generating the randomization sequence, allocation concealment was ensured by using sealed opaque envelopes containing a paper marked "A" or "B". Each batch consisted of two envelopes marked "A" and two marked "B", shuffled in a basket before the participant’s selection. Upon choosing an envelope, each participant entered the designated consulting room and handed it to the principal investigator, who then opened it and revealed the arm allocation without participants’ knowledge (Blinding). Participants assigned to "A" were placed in the intervention arm, while those assigned to "B" were placed in the control arm. This process continued until the sample size was achieved. Intervention arm A pretested questionnaire designed for this study was adapted from the WHO STEPS questionnaire and administered to the participants in both intervention and control arms. The questionnaire captured information on socio-demographic variables (age, sex, marital status, tribe, religion, hospital number, and address), lifestyle practices (smoking, alcohol intake, dietary habits, and physical activity) and anthropometric (weight and height for BMI) and clinical (blood pressure and HbA1c) data were also collected at baseline and post-intervention. 20 Their telephone numbers were collected for sending reminders on adherence to drugs and practicing a healthy lifestyle. A pre-recorded standardized short message, derived from script containing (Greetings to you. Watch your weight, limit unhealthy diet eating, take multivitamins, Drink clean water regularly, Avoid sugared beverages, Exercise regularly for 30–45 minutes three or more times a week, avoid excess or cut down alcohol consumption, stop cigarette smoking) was sent to each of them every three week (5 times over the period of the study), uniformly in English or Hausa (with Hausa being the predominant local language). The 5As counselling technique was used, with each participant’s counselling session lasting 15–30 minutes depending on level of their understanding. The 5As is a validated counselling tool used globally and locally as follows: 13 ASK: Have you set any goals for healthy eating, increasing physical activity, stopping smoking and decreasing or stopping alcohol consumption? ASSESS: Do you have any difficulty in sticking to your plans? Let’s talk on how we can work on them together. ADVISE: Remember to eat more fruits and vegetables, remember to eat lean protein, whole grains, > 30 minutes of physical activity 3 times a week, stop smoking, stop or cut down alcohol consumption. ASSIST: Let’s discuss some easier strategies and incorporate them into your daily activities. Use stairs not elevator, connect to support groups, the community, chew nicotine gums, use nicotine patch, eat more vegetables and fruits and more whole grains and cut down or stop alcohol consumption. ARRANGE: Let’s schedule our meetings every four weeks to discuss any challenges and to keep track of your progress. 12–13 The components of the WHO STEPS include: Diet: The number of fast foods they ate, how many servings per day in a typical week, > 2 servings does not meet criteria = 0, none or less than 2 met criteria = 1. Vegetables and Fruits eating per day in a typical week: none (does not meet criteria = score of 0); 2 (met criteria = 1). Carbonated drinks: Consumption of carbonated soft drinks on a usual day of the week (a) 1–2 times= score of 1, > 2 time = 0 Physical Activity: per week for Age ≥ 18years: 150 minutes /week = 1. Alcohol use: yes answer (does not meet criteria = 0), No answer (met criteria = 1). Tobacco use (smoking): smoker = 0 (b) non-smoker = 1. Lifestyle practices were assessed with the Healthy behaviour score (HBS): This tool tracks the number of healthy and unhealthy lifestyle(s) of an individual. It is a well-validated tool that measures and assigns a score to lifestyle practices. 12 , 14 The score ranges from 1 to 4. The score of 1 is the lowest, while four is the highest. The score of 1 and 2 indicate an inadequate (unhealthy) Lifestyle, while a score of 3 and 4 indicate adequate (healthy) lifestyle practices. Participants who did not have a functioning phone were reached through their spouses, children or close relatives (a total of two phone numbers, from the index patient and a close relative were obtained). Information leaflets on dietary education (in Hausa or English) were also given to each of them. Glycated Heamoglobin (HbA1c): Measured based on the widely accepted guidelines by the American Diabetes Association (ADA), and the International Diabetes Federation (IDF), an HbA1c level of less than 7% indicated good glycaemic control, while values 7% and above was recorded as poor glycaemic control. 15 Control Arm Each participant in the control arm had the questionnaires administered in English and Hausa and received standard care for diabetic patients. Their blood samples were collected for HbA1c. They received neither structured lifestyle counselling nor telephone call reminders. However, they were given dietary education leaflets. Follow up There was follow-up at the 4th week and 12th week (a total of 16 weeks) for the intervention arm only. Participants in both arms were seen at the 16th week for the post intervention follow-up, depending on their recruitment week, for re-assessment of lifestyle practices/clinical parameters. At the end of the intervention period, follow-up measurements were taken for both the intervention and control arms at the 16th week, including HbA1c, blood pressure, weight, and height (for BMI). These parameters were used to evaluate the effect of the intervention on glycaemic control and other lifestyle-related outcomes. The study adheres to and was reported according to CONSORT guidelines as depicted in Fig. 1 . Data Analysis The collected data were analysed using IBM® SPSS version 23. The categorical variables, such as sex, residence, marital status, occupation, wereexpressed in frequencies and percentages, while mean and standard deviation were used for continuous variables such as age, FBG, HbA1c, BMI or median and interquartile range where appropriate. Chi-square was used for the association between categorical variables and Wilcoxon signed ranked test was used to find the median decrease in glycaemic control. A p-value of < 0.05 was considered statistically significant. Ethical Consideration Ethical approval was obtained from the Health Research Ethics Committee of Aminu Kano Teaching Hospital (Appendix A: NHREC number 28/01/2020/AKTH/EC/3439AKTH). The study was conducted according to the Helsinki Declaration. RESULTS Baseline socio-demographic and clinical characteristics of study participants The data of 119 participants were analysed out of the 126 participants initially recruited for the study, with an attrition rate of 6%. The majority 60 (50.4%) of the participants belonged to the middle-aged group with a mean age of 55.9 ± 11.54 years. Females constituted a larger proportion of the participants 77 (64.7%), and full-time housewives 45(37.8%), was the predominant occupation. Most participants were Muslims, 116 (97.5%), urban dwellers, 101(84.9%) and had Qur’anic level of education. Majority of the study participants, 77 (64.7%) came from monogamous families. At baseline there was no statistically significant difference in sociodemographic and clinical characteristics between the intervention and control arms (Table 1and Table 2 ). Table 2 Baseline comparison of clinical characteristics Variables Control (n = 60) Intervention (n = 59) 𝛘 2 p-value FAMILY HISTORY OF DIABETES Absent 25 (61.0%) 16 (39.0%) 2.788 0.095 Present 35 (44.9%) 43 (55.1 (%) BMI 3.128* 0.396 Underweight 0 (0.0%) 3 (100.0%) Normal weight 22 (50.0%) 22 (50 .0%) Overweight 19 (55.9%) 15 (44.1%) Obese 18 (48.6%) 19 (51.4%) FBS GLYCAEMIC CONTROL 0.014 0.906 Controlled 23 (51.1%) 22 (48.9%) Uncontrolled 37 (50.4%) 37 (50.0%) HbA1C GLYCAEMIC CONTROL 1.373 0.241 Controlled 5 (35.7%) 9 (64.3%) Uncontrolled 55 (52.4%) 50 (47.6%) *: Fisher’s exact test, Bold : Statistically significant Table 1 Baseline comparison of the sociodemographic characteristics Variables Control (n = 60) Intervention (n = 59) Total (n = 119) 𝛘 2 p-value AGE Young 5 (45.5%) 6 (54.5%) 11(9.2%) Middle age 29 (48.3%) 31 (51.7%) 60(50.4%) 0.438 0.786 Elderly 26 (54.2%) 22 (54.8%) 48(40.4%) SEX Male 23 (54.8%) 19 (45,2%) 42(35.3%) Female 37 (48.1%) 40 (51.9%) 77(64.7%) 0.489 0.484 RESIDENCE Urban 53 (52.5%) 48 (47.5%) 101(84.9%) Rural 7 (38.9%) 11 (61.1%) 18(15.5%) 1.128 0.288 OCCUPATION Business/trading 21(51.2%) 20(48.8%) 41(34.5%) Full time housewife 21(51.2) 24(48.8) 45(37.8) Driving 1 (50.0%) 1 (50.0%) 2(1.7%) 1.439* 0.954 Civil servant 4 (44.4%) 5 (55.6%) 9(7.6%) Unemployed 8 (57.1%) 6 (42.9%) 14(11.8) Farmer 5 (62.5%) 3 (37.5%) 8(6.6) EMPLOYMENT Unemployed 29 (49.2%) 30 (50.8%) 59(49.6%) Employed 31 (51.7%) 29 (48.3%) 60(50.4%) 0.075 0.784 MARITAL STATUS Single 2 (40.0%) 3 (60.0.) 5(4.2%) Married 47 (54.0%) 40 (46.0%) 87(73.1%) Divorced 1 (25.0%) 3 (75.0%) 4(3.4%) 2.148* 0.558 Widowed 10 (43.5%) 13(56.5%) 23(19.3%) RELIGION Islam 58 (50.0%) 58 (50.0%) 116(97.5%) Christianity 2 (66.7%) 1 (33.3%) 3(2.5%) 0.005* 1.000 TRIBE Hausa 39 (48.1%) 42 (51.9%) 81(68.1%) Fulani 11 (45.8%) 13 (54.2%) 24(20.2%) Yoruba 1 (100.0%) 0 (0.0%) 1(0.8%) 3.444 0.496 Igbo 1 (100.0%) 0 (0.0%) 1(0.8%) Others 8 (66.7%) 3 (69.0%) 12(10.1%) EDUCATION None 0 (0.0%)) 2 (100.0%) 2(1.7%) Qur’an 28 (48.3%) 30 (51.7%) 58(48.7%) Primary 8 (53.3%) 7 (46.7%) 15(12.6%) 2.566 0.633 Secondary 11 (52.4%) 10 (47.6%) 21(17.6%) Tertiary 13 (56.5%) 10 (43.5%) 23(19.4%) FAMILY TYPE Monogamous 37 (48.1%) 40 (41.9%) 77(64.7%) 0.489 0.484 Polygamous 23(54.8%) 19(45.2%) 42(35.3%) Baseline comparison of lifestyle practices Table 3 shows the baseline comparison of the lifestyle practices of participants in both arms of the study. There were no significant differences in snack consumption, fruit consumption, vegetables consumption, fast-food consumption, carbonated drink consumption, physical activity levels and tobacco smoking status between the participants in the control and intervention arms of the study (p > 0.05). Table 3 Baseline comparison of lifestyle practices Variables Control (n = 60) Intervention (n = 59) 𝛘 2 p-value SNACK CONSUMPTION 0.439 0.507 No 16 (45.7%) 19 (54.3%) Yes 44 (52.4) 40 (47.6%) FRUIT CONSUMPTION 3.396 0.183 None 5 (35.7%) 9 (64.3%) 1 to 2 servings per day 11 (68.8%) 5 (31.3%) More than 2 servings per day 44 (49.4%) 45 (50.6%) VEGETABLE CONSUMPTION 0.320005 0.850 None 2 (66.7%) 1 (33.4%) 1 to 2 servings per day 27 (50.0%) 27 (50.0%) More than 2 servings per day 41 (50.0%) 41 (50.0%) FAST FOOD CONSUMPTION 0.417* 0.817 None 34 (48.6%) 36 (51.4%) 1 to 2 servings per day 3 (60.0%) 2 (40.0%) More than 2 servings per day 23 (52.3%) 21 (47.7%) CARBONATED DRINKS 1.455* 0.509 None 45 (47.9%) 49 (52.1%) 1 to 2 servings per day 2 (50.0%) 2 (50.0%) More than 2 servings per day 13 (61.9%) 8 (38.1%) PHYSICAL ACTIVITY 0.784 0.676 None 10 (55.6%) 8 (44.4%) Less than 150 minutes per week 36 (47.7%) 40 (52.6%) More than 150 minutes per week 14 (56.6%) 11 (44.0%) SMOKING 1.000* Yes 1 (100.0%) 0 (0.0%) No 59 (50.0%) 59 (50.0%) *: Fisher’s exact test, Bold : Statistically significant Pre- intervention lifestyle practices with healthy behaviour score Figure 2 show that 53.6% of participants in the control arm and 46.4% in the intervention arm were engaged in unhealthy lifestyle behaviours. Conversely, 49.5% of the control arm and 50.5% of the intervention arm had healthy lifestyle behaviours. However, these relationships were not statistically significant (𝛘 2 = 0.145 and p-value of 0.703). < Post-intervention lifestyle practices with healthy behaviour score Figure 3 : Post-intervention, there was a significant difference in healthy behaviour scores between the control and intervention arms (𝛘 2 = 29.298, p < 0.001); suggesting clearly, that the intervention had an effect on the participants’ lifestyle practices. < Pre- and post-intervention glycaemic control. Figure 4 a and 4 b shows the median FBG decreased in intervention arm from 7.8mmol/L pre-intervention to FBG was 6.0 mmol/L post-intervention, also in the control arm from 7.6mmol/L to 6.5 mmol/L there was a statistically significant improvement in FBG post-intervention among both intervention (z = -4.124, p-value = < 0.001) and control arm (z = -3.225, p-value = 0.001). Similarly, the median HbA1c in the intervention arm decreased from 8.4% pre-intervention to 7.0% post-intervention, while in the control arm it decreased from 8.2% to 7.1%. Using the Wilcoxon signed-rank test, this reduction was statistically significant in both the intervention arm (z = -3.774, p < 0.001) and the control arm (z = -3.158, p = 0.002 ). However, the effect of counselling on glycaemic control was not statistically significant (𝛘 2 = 3.517 p = 0.061) as depicted in Table 4 . Table 4 Effect of Counselling on Glycaemic control Variables Controlled (n = 60) Uncontrolled (n = 59) 𝛘 2 p-value RR CI FBS glycaemic control 3.517* 0.061 0.82 0.60–1.02 Intervention 35 (58.3%) 25 (41.7%) Control 44 (74.6%) 15 (25.4%) HBA1C glycaemic control 0.005* 0.944 0.983 0.62–1.57 Intervention 22 (36.7%) 38 (63.3%) Control 22 (37.3%) 3 (62.7%) *: Fisher’s exact test, Bold : Statistically significant < DISCUSSION The lifestyle practices assessed in this study included physical activity, cigarette smoking, alcohol consumption, and dietary habits. The findings revealed that participants who received lifestyle modification interventions demonstrated improved knowledge, increased adoption of health-promoting behaviours, and better glycaemic control than those in the control group. Similar to our findings, Kadriye et al, in Turkey, reported a good alignment between the counselling intervention and the Information–Behaviour–Motivation (IBM) model utilised. 16 The intervention demonstrated a statistically significant difference between the intervention and control groups. 16 This may be attributed to participants effectively applying the counselling received in familiar language with repetitive telephone reminders, thereby translating knowledge into appropriate lifestyle practices. Similarly, Haque et al, in Malaysia, employed the use of weekly SMS messages to participants with various NCDs like lung cancer, obesity, metabolic syndrome, Chronic Obstructive Airway Disease COPD, Hypertension and Diabetes mellitus, as the primary counselling strategy. 17 However, our study employed a structured one-on-one LSM counselling session delivered once, and three weekly reminders (5 sessions in all). Nonetheless, both studies share the common objective of promoting cost-effective lifestyle modification, highlighting the potential effectiveness of brief, engaging messages both in low-middle-income countries. 17 Inversely, Marjanović et al, found that 43.3% of patients had unhealthy diets, 56.0% were physically inactive, and 26.3% were smokers and had poorly controlled glycaemia 36.8% because of poor adherence to lifestyle intervention counselling. The reason for dissimilarities could likely be related to the different lifestyle assessment tools, as we used the WHO Steps HBS composite score while they used the Perceived Stress Scale to examine stress in lifestyle behaviour. 18 In this study, we documented a significant decrease in median HbA1c post-intervention in both arms. However, the effect of structured counselling on glycaemic control was not statistically significant. The improvement with no statistical difference may probably be related to the duration of the study, 22 weeks, less than six months, when the effect of most intervention is observed. Conversely, Ibrahim et al, in Egypt, also reported that LSM counselling interventions can lead to improvements in glycaemic control and health outcomes among type-2 diabetic patients. 19 In contrast to our findings, Kumari et al, found statistically significant improvements in fasting blood glucose and HbA1c levels post-intervention. The difference may be attributed to the use of a holistic model in counselling participants, which may have provided a more comprehensive and effective approach and a longer follow-up period of 12 months. 7 The limitations of our study were related to duration of the intervention 22 weeks only and although the study was RCT been hospital-based limit its external validity. However, the strengths are the findings of this study suggest exploring other alternatives or adjunct interventions in the place of face-to-face LSM counselling sessions, such as telephone reminders, and mobile Apps use. These should be encouraged both in busy resource-limited and even resource-abundant settings. Further longitudinal long-term studies to assess sustained effects and investigate dose–response relationships between reminders and outcomes should be considered. Implementation science research on the cost effectiveness, appropriateness, acceptability, feasibility, of technology feedback loops should also be considered. CONCLUSION There was a statistically significant difference between the participants who were counselled on lifestyle practices and those who were not counselled. Although there was an improvement in glycaemic control post-intervention in both arms, the difference was not statistically significant. These findings highlight the value of lifestyle counselling in diabetes care and suggest that additional or complementary strategies may be needed to enhance glycaemic outcomes. Further research with larger sample sizes and extended follow-up is recommended. Abbreviations AKTH Aminu Kano Teaching Hospital BMI Body Mass Index DM Diabetes Mellitus FBG Fasting Blood Glucose HbA1C Glycated Heamoglobin HBS Healthy behaviour score LSM Lifestyle Modification RCT Randomised Controlled Trial T2DM Type-2 Diabetes Mellitus Declarations Consent to Participate All participants signed informed written consent and ethical approval was obtained for the study from the Health Research Ethics Committee of Aminu Kano Teaching Hospital (NHREC number 28/01/2020/AKTH/EC/3439AKTH). Consent for publications – Not applicable Data availability Data will be available on reasonable request according to data privacy agreement of the institution. Funding The research was fully funded by the authors. There was no external funding received. Acknowledgment We appreciate all the participants for their time and voluntary participation. Conflict of Interest None to declare Authors contribution AAG, ZA - Research conceptualization and initial manuscript writing ZA, FMD, ALO, AKS AAY- manuscript writing and review AAG, TTO, ALO, ZA – data collection and analysis ZA, AKS, FMD, ALO, TAB,GMC, BAG – Review figures, tables and senior advisory input All authors- Review manuscript and provide final approval for publication. References Kumari G, Singh V, Jhingan AK, Dahiya S. Impact of Lifestyle Modification Counseling on Quality of Life of Type 2 Diabetes Mellitus Patients using Appraisal Scale of Diabetes. Int J Adv Sci Eng Technol. 2017;5(2):70–2. Naumann F. Classification of diabetes mellitus [Internet]. World Helath Organization. 2019 [cited 2022 Jun 5]. pp. 1–28. Available from: https://apps.who.int/iris/rest/bitstreams/1233344/retrieve Boyko EJ, Magliano DJ, Karuranga S, Piemonte L, Saeedi PRP, Sun H. IDF Diabetes Atlas [Internet]. 10th ed. International Diabetes Federation; 2021. 1–141 p. Available from: www.diabetesatlas.org %7C. Ibrahim F, Megahed AL, Hassan SAA, Abdelwahid HA, Farg HK. Effect of Lifestyle Modification on Glycemic Control of Type 2 Diabetic Patients at Suez Canal University Hospitals. Intech Open. 2021;3:1–28. Uloko AE, Musa BM, Ramalan MA, Gezawa ID, Puepet FH, Uloko AT, et al. Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Ther. 2018;9(3):1307–16. Josh Reed, Stephen Bain VK. A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments and Future Perspecext Article REVIEW A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments and Future Perspect. J Diabetes metabolic Syndr obesitytargets Ther. 2021;14:3567–602. Kumari G, Singh V, Jhingan AK. Effectiveness of Lifestyle Modification Counseling on Glycemic Control in Type 2 Diabetes Mellitus Patients. Curr Res food Sci. 2018;06(1):70–82. Salihu DA, Yohanna S. The effect of structured counselling on lifestyle modification measures among adult pre-hypertensive patients in a tertiary hospital in North Central Nigeria. Niger J Med. 2019;28:118–26. Vishwanath J. The Concept Behind Sample Size Calculation for Randomised Control Trials. A Review. Sci Acta Heal Nutr. 2019;3(2):90–3. Bolarinwa OA. Sample Size Estimation for Health and Social Science Researchers: The Principles and Considerations for Different Study Designs. Natl post Grad Med J. 2020;27(2):67–75. Gezawa ID, Uloko AE, Gwaram BA, Ibrahim DA, Ugwu ET, Mohammed IY. Pattern of obesity among patients with type 2 diabetes at a tertiary healthcare center in Northern Nigeria. Diabetes, Metab Syndr Obes Targets Ther. 2019;12:2785–90. Statcan. Lifestyle practice Health Behaviour score [Internet]. Canadian health fact sheet. 2016 [cited 2023 Apr 16]. Available from: https://www150.statcan.gc.ca/n1/pub/82-625-x/82-625-x2017001-eng.htm WHO. Toolkit for delivering the 5A’s and 5R ’s brief tobacco interventions in primary care. World Helath Organ. 2014:1–17. Michael GC, Ehalaiye DN, Ibrahim H, Falaki FA, Suleiman AK, Grema BA, et al. Assessment of workhour feeding practices, healthy behaviour score and body mass index of physicians in Northern Nigeria: a cross-sectional multi-centre study. J Prev Med Hyg. 2024;65(1):E73–82. American Diabetic Association Standard of Medical Care in Diabetes: Updates 2025. Acessed. 3rd June 2025 available at https://professional.diabetes.org/standards-of-care Kadriye SK, Guler DA, Cemile KY, Canlar Ş. The effect of model-based telephone counseling on HbA1c and self-management for individuals with type 2 diabetes: A randomised controlled trial. Prim Care Diabetes. 2022;16(1):41–8. Haque M. Lifestyle Changes in the Management of Non-Communicable Diseases in Low and Middleincome Countries. Int J Hum Heal Sci. 2020;5(1):4–6. Marjanović M, Đido V, Bralić Lang V, Martinović Ž, Ovčina A. The Association of Clinical Characteristics and Lifestyle Habits with Poor Glycemic Control in Patients with Type 2 Diabetes Mellitus. Eur J Med Heal Sci. 2021;3(1):79–84. Ibrahim F, Megahed AL, Hassan SAA, Abdelwahid HA, Farg HK. Effect of Lifestyle Modification on Glycemic Control of Type 2 Diabetic Patients at Suez Canal University Hospitals. Intech Open. 2021;3:1–28. https:// docs.google.com/document/d/1uMJp2wezmc5wkZTqJUFPRzMWFs7 xCPCo/edit?usp=drivesdk&ouid=106491892114506665198&rtpof=true&sd=true Additional Declarations No competing interests reported. Supplementary Files CONSORT2025checklistLIFESTYLE.docx QUESTIONNAIRESLICT2DTRIAL.docx Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 08 May, 2026 Reviews received at journal 14 Mar, 2026 Reviews received at journal 11 Mar, 2026 Reviews received at journal 08 Mar, 2026 Reviewers agreed at journal 08 Mar, 2026 Reviewers agreed at journal 06 Mar, 2026 Reviewers agreed at journal 05 Mar, 2026 Reviewers agreed at journal 24 Feb, 2026 Reviewers invited by journal 24 Feb, 2026 Editor assigned by journal 23 Feb, 2026 Editor invited by journal 29 Jan, 2026 Submission checks completed at journal 28 Jan, 2026 First submitted to journal 28 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8658846","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":597738837,"identity":"700b5eae-f182-4ce6-852c-4ac1da0cfd57","order_by":0,"name":"Aisa Abba Gana","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Aisa","middleName":"Abba","lastName":"Gana","suffix":""},{"id":597738838,"identity":"a63d96d8-34a1-46af-8377-89a51fa6ddee","order_by":1,"name":"Zainab Abdulkadir","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYPACGx42/uYDQIaEDLFa0uT4JY4lgLTwEKvlsLFkQ44BiEVYi/y0wwcfF9QwJ244cObzqxs1FjwM7IePbsCnhXF2WrLxjGNsiRsO926zzjkGdBhPWtoNfFqYpXPMpHnYeIC2nN1mnMMG1CLBY4ZXC5t0/vffPP8kgFpynhnn/CNCC490Dhszb5sByPvMj3PbiNAiIZ1mLM3blwAKZDPm3D4JoCMJ+EV+dvLDzzzf/oOi8vHnnG91cvzsh4/h1YLiLwkwSaxyEGD+QIrqUTAKRsEoGDkAALvCRGztCj68AAAAAElFTkSuQmCC","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":true,"prefix":"","firstName":"Zainab","middleName":"","lastName":"Abdulkadir","suffix":""},{"id":597738839,"identity":"f0887f84-3afc-40c5-b5da-5bd7a0e77d2e","order_by":2,"name":"Fatima Mohammed Damagum","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Fatima","middleName":"Mohammed","lastName":"Damagum","suffix":""},{"id":597738840,"identity":"7d9b5c69-d762-4710-ae26-d06336b7e58e","order_by":3,"name":"Tiri Titilope Ogunyele","email":"","orcid":"","institution":"Federal Medical Centre Nguru Yobe","correspondingAuthor":false,"prefix":"","firstName":"Tiri","middleName":"Titilope","lastName":"Ogunyele","suffix":""},{"id":597738841,"identity":"df5e2727-fb89-44e9-9f3f-8604ba954d61","order_by":4,"name":"AbdulGafar Lekan Olawumi","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"AbdulGafar","middleName":"Lekan","lastName":"Olawumi","suffix":""},{"id":597738842,"identity":"b3a6f5be-4532-4d17-8f39-6a25ebbccafd","order_by":5,"name":"Godwin Uzoma Iroezindu","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Godwin","middleName":"Uzoma","lastName":"Iroezindu","suffix":""},{"id":597738843,"identity":"c06bb554-d7ed-4725-ae18-4970fbfa0309","order_by":6,"name":"Abdullahi Kabir Suleiman","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Abdullahi","middleName":"Kabir","lastName":"Suleiman","suffix":""},{"id":597738845,"identity":"408d55ec-7112-4639-a597-f653edb56fcc","order_by":7,"name":"Aminatu A. Kwaku","email":"","orcid":"","institution":"Bayero University","correspondingAuthor":false,"prefix":"","firstName":"Aminatu","middleName":"A.","lastName":"Kwaku","suffix":""},{"id":597738846,"identity":"6f37c32a-9f2c-4eec-aa61-8bfa2fb4926b","order_by":8,"name":"Tsuung Ason Benjamin","email":"","orcid":"","institution":"Yobe State University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Tsuung","middleName":"Ason","lastName":"Benjamin","suffix":""},{"id":597738850,"identity":"cbf54eb2-0aee-423d-8207-1a32baafded2","order_by":9,"name":"Godpower Chinedu Michael","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Godpower","middleName":"Chinedu","lastName":"Michael","suffix":""},{"id":597738851,"identity":"90e67057-c0eb-473b-8a31-c9cfadd5b932","order_by":10,"name":"Bukar A. Grema","email":"","orcid":"","institution":"Aminu Kano Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Bukar","middleName":"A.","lastName":"Grema","suffix":""}],"badges":[],"createdAt":"2026-01-21 11:20:52","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8658846/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8658846/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104399730,"identity":"e22a4f6c-87c8-4193-884e-bfeaf3f8d7d1","added_by":"auto","created_at":"2026-03-11 12:07:26","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":87541,"visible":true,"origin":"","legend":"\u003cp\u003eConsort flow chart of study participants\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/f7c2cddff6ffebd04d553fbf.jpg"},{"id":103728746,"identity":"c5efa678-801f-400f-b1ba-927f459dbef7","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":149868,"visible":true,"origin":"","legend":"\u003cp\u003ePre-intervention Life style practices with Healthy behaviour Score\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/aa6147bb253ab67710f096d9.jpg"},{"id":103728748,"identity":"adddff37-7ffb-4c73-81d3-4c233fcb3548","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":165102,"visible":true,"origin":"","legend":"\u003cp\u003ePost-intervention Life style practices with Healthy behaviour Score\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/bdde5a66ff45c7679cb54e49.jpg"},{"id":103728749,"identity":"7651bc13-00fc-4451-8594-d93052f7fed4","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":62562,"visible":true,"origin":"","legend":"\u003cp\u003e4a: Pre- and post-intervention glycaemic control with FBG\u003c/p\u003e","description":"","filename":"4a.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/407422678a2ffc0c320f9537.jpg"},{"id":103728750,"identity":"26a07522-a5c0-4dda-87d0-21b53e2199e9","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"jpg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":78380,"visible":true,"origin":"","legend":"\u003cp\u003e4b: Pre- and post-intervention glycaemic control with HbA1c\u003c/p\u003e","description":"","filename":"4b.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/b6b976c9742a2042f0b647ee.jpg"},{"id":104407600,"identity":"52c47e68-94ff-4104-9ece-066d79739132","added_by":"auto","created_at":"2026-03-11 12:39:03","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1836851,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/94dc597f-a6d3-4dbd-a546-30e5a5c48816.pdf"},{"id":103728744,"identity":"644ea03a-363f-4fbd-93b6-4c2d7bdcc015","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":38034,"visible":true,"origin":"","legend":"","description":"","filename":"CONSORT2025checklistLIFESTYLE.docx","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/d477261fbda97b9f2b1d0bc8.docx"},{"id":103728753,"identity":"ae4e9a54-d3e5-4e8e-b185-5193456281ec","added_by":"auto","created_at":"2026-03-02 08:43:53","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":40804,"visible":true,"origin":"","legend":"","description":"","filename":"QUESTIONNAIRESLICT2DTRIAL.docx","url":"https://assets-eu.researchsquare.com/files/rs-8658846/v1/d6dac08585a91002fe2bdeb9.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eDiabetes Mellitus (DM) is a major cause of increased morbidity and mortality as well as a decreased quality of life.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e DM also accounts for 1.9% of the global disability-adjusted years (DALY). \u003csup\u003e1\u0026ndash;4\u003c/sup\u003e According to the International Diabetes Federation Atlas 2021, there is progressive prevalence around the world that affected 537\u0026nbsp;million adults (20\u0026ndash;79 years). The number is expected to rise to 643\u0026nbsp;million by 2030 and 783\u0026nbsp;million by 2045, with approximately 81% of those living with diabetes residing in low- and middle-income countries such as Nigeria.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e According to the World Health Organization (WHO), Ethiopia, South Africa, the Democratic Republic of Congo, Nigeria, and Tanzania were the top five African nations in 2017 with a high number of persons with diabetes mellitus (18\u0026ndash;99 years).\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e In Nigeria, Uloko et al reported that Type-2 Diabetes Mellitus (T2DM ) pooled prevalence in 2017 was highest in the south-south (9.8%) and lowest in the North-west (3.0%), posing a greater risk to the health system.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e The risk factors associated with T2DM and its management are both modifiable and non-modifiable. The modifiable risk factors are mostly behavioural and lifestyle practices such as excess use of high-calorie diet, lack of exercise, excess alcohol intake and cigarette smoking. Hence, there is a need to promote a healthy lifestyle via structured lifestyle modification counselling.\u003c/p\u003e \u003cp\u003eEarly and intensive non-pharmacological intervention reduces the risk of microvascular and macrovascular complications and slows disease progression in T2DM.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Good glycaemic control may be achieved through lifestyle modification counselling and adherence to structured lifestyle intervention, which in turn decreases morbidity/mortality/disability.\u003csup\u003e7\u003c/sup\u003e In non-DM people, lifestyle modification helps to prevent T2DM or other cardiovascular risk factors.\u003c/p\u003e \u003cp\u003eThere is a dearth of information on the combined use of lifestyle modification counselling and telephone reminders to promote adherence to healthy lifestyle practices in a busy setting like ours. This is imperative, given the doctor-patient ratio in resource-limited settings which will not allow one-on-one lifestyle modification (LSM) counselling of T2DM at every visit due to resource constraints. Hence, the need for this study, which assessed the effect of structured LSM which combines one-on-one single counselling with subsequent telephone reminders of pre-recorded messages in a language patients are more familiar with. This may be an innovative way to promote a healthy lifestyle and optimize glycaemic control among T2DM patients attending primary care in resource-limited climes like ours.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy population and design\u003c/h2\u003e \u003cp\u003eThe study was a superiority parallel, 1:1 ratio randomised controlled trial conducted over a period of 22 weeks, among Type 2 diabetes mellitus patients aged 18 years and above who have been receiving the routine care for \u0026ge;\u0026thinsp;6 months at the Family Medicine Clinic of Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Those excluded were patients who had diabetic emergencies, pregnant women and patients with documented cognitive impairment.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample size estimation\u003c/h3\u003e\n\u003cp\u003eThe desired sample size was estimated using formula \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:N=2\\:\\left[\\frac{{\\left({Z}_{\\alpha\\:}+\\:{Z}_{\\beta\\:}\\right)}^{2}}{{\\left(\\delta\\:\\right)}^{2}}\\right]X\\:\\)\u003c/span\u003e\u003c/span\u003e S\u003csup\u003e2\u003c/sup\u003e for continuous variable.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e Where, \u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:\\text{N}\\:\\text{M}\\text{i}\\text{n}\\text{i}\\text{m}\\text{u}\\text{m}\\:\\text{s}\\text{a}\\text{m}\\text{p}\\text{l}\\text{e}\\:\\text{s}\\text{i}\\text{z}\\text{e}\\:\\text{f}\\text{o}\\text{r}\\:\\text{e}\\text{a}\\text{c}\\text{h}\\:\\text{o}\\text{f}\\:\\text{t}\\text{h}\\text{e}\\:\\text{s}\\text{t}\\text{u}\\text{d}\\text{y}\\:\\text{a}\\text{r}\\text{m}\\)\u003c/span\u003e\u003c/span\u003e\u003cdiv id=\"Equa\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equa\" name=\"EquationSource\"\u003e\n$$\\:\\text{Z}{\\alpha\\:}=\\text{L}\\text{e}\\text{v}\\text{e}\\text{l}\\:\\text{o}\\text{f}\\:\\text{s}\\text{t}\\text{a}\\text{t}\\text{i}\\text{s}\\text{t}\\text{i}\\text{c}\\text{a}\\text{l}\\:\\text{s}\\text{i}\\text{g}\\text{n}\\text{i}\\text{f}\\text{i}\\text{c}\\text{a}\\text{n}\\text{c}\\text{e}\\:\\text{a}\\text{t}\\:95\\text{\\%}\\:\\text{c}\\text{o}\\text{n}\\text{f}\\text{i}\\text{d}\\text{e}\\text{n}\\text{c}\\text{e}\\:\\text{l}\\text{e}\\text{v}\\text{e}\\text{l}=1.96$$\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Equb\" class=\"Equation\"\u003e\u003cdiv format=\"TEX\" class=\"mathdisplay\" id=\"FileID_Equb\" name=\"EquationSource\"\u003e\n$$\\:\\text{Z}{\\beta\\:}\\:=\\text{D}\\text{e}\\text{s}\\text{i}\\text{r}\\text{e}\\text{d}\\:\\text{p}\\text{o}\\text{w}\\text{e}\\text{r}\\:\\text{o}\\text{f}\\:80\\text{\\%}\\:\\:=0.84$$\u003c/div\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\:{\\mu\\:}_{1}=\\)\u003c/span\u003e \u003c/span\u003e7.9mmol/L, the mean fasting blood glucose (FBG) level from a previous study at AKTH.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eS\u0026thinsp;=\u0026thinsp;Standard deviation\u0026thinsp;=\u0026thinsp;2.8mmol/L.\u003csup\u003e11\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e \u003cspan class=\"InlineEquation\"\u003e \u003cspan class=\"mathinline\"\u003e\\(\\:\\delta\\:\\)\u003c/span\u003e \u003c/span\u003e = Effect size, which was the hypothesized clinically significant difference detectable in the mean FBG levels (assuming a 20% reduction from 7.9mmol/L)\u0026thinsp;=\u0026thinsp;1.58mmol/L\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;49.24 (Rounded up to 50 participants in each arm)\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;N/ (1-r), where, r was the loss to follow-up rate.\u003c/p\u003e \u003cp\u003eTherefore, the adjusted N\u0026thinsp;=\u0026thinsp;50/0.8\u0026thinsp;=\u0026thinsp;63.\u003c/p\u003e \u003cp\u003eTherefore, 63 participants were recruited per study arm, for a total of 126 participants.\u003c/p\u003e\n\u003ch3\u003eStudy procedure\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSampling method\u003c/h2\u003e \u003cp\u003eA systematic sampling technique was used and 126 participants selected over a period of six weeks, with a sampling interval where every 6th participant was selected. The first participant was selected by simple random sampling through ballot. Informed written consent was obtained from all the participants and confidentiality was ensured.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eRandomisation\u003c/h3\u003e\n\u003cp\u003eAfter initial recruitment for 6 weeks, participants were randomly divided into blocks of four at random (using a table of random numbers), with half of the participants in each block assigned to the intervention and the other half to the control arm. A trained and experienced research assistant with over seven years of involvement in similar hospital-based research facilitated the randomization process. Patients were recruited in blocks of four at a time such that there were six possible ways of allocating intervention with two patients allotted to group A and two patients allotted to group B per block. The six possible ways of allocating the blocks of size four include AABB, ABAB, ABBA, BBAA, BABA and BAAB. After generating the randomization sequence, allocation concealment was ensured by using sealed opaque envelopes containing a paper marked \"A\" or \"B\". Each batch consisted of two envelopes marked \"A\" and two marked \"B\", shuffled in a basket before the participant\u0026rsquo;s selection. Upon choosing an envelope, each participant entered the designated consulting room and handed it to the principal investigator, who then opened it and revealed the arm allocation without participants\u0026rsquo; knowledge (Blinding). Participants assigned to \"A\" were placed in the intervention arm, while those assigned to \"B\" were placed in the control arm. This process continued until the sample size was achieved.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eIntervention arm\u003c/h2\u003e \u003cp\u003eA pretested questionnaire designed for this study was adapted from the WHO STEPS questionnaire and administered to the participants in both intervention and control arms. The questionnaire captured information on socio-demographic variables (age, sex, marital status, tribe, religion, hospital number, and address), lifestyle practices (smoking, alcohol intake, dietary habits, and physical activity) and anthropometric (weight and height for BMI) and clinical (blood pressure and HbA1c) data were also collected at baseline and post-intervention.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Their telephone numbers were collected for sending reminders on adherence to drugs and practicing a healthy lifestyle. A pre-recorded standardized short message, derived from script containing (Greetings to you. Watch your weight, limit unhealthy diet eating, take multivitamins, Drink clean water regularly, Avoid sugared beverages, Exercise regularly for 30\u0026ndash;45 minutes three or more times a week, avoid excess or cut down alcohol consumption, stop cigarette smoking) was sent to each of them every three week (5 times over the period of the study), uniformly in English or Hausa (with Hausa being the predominant local language). The 5As counselling technique was used, with each participant\u0026rsquo;s counselling session lasting 15\u0026ndash;30 minutes depending on level of their understanding. The 5As is a validated counselling tool used globally and locally as follows: \u003csup\u003e13\u003c/sup\u003eASK: Have you set any goals for healthy eating, increasing physical activity, stopping smoking and decreasing or stopping alcohol consumption? ASSESS: Do you have any difficulty in sticking to your plans? Let\u0026rsquo;s talk on how we can work on them together. ADVISE: Remember to eat more fruits and vegetables, remember to eat lean protein, whole grains, \u0026gt;\u0026thinsp;30 minutes of physical activity 3 times a week, stop smoking, stop or cut down alcohol consumption. ASSIST: Let\u0026rsquo;s discuss some easier strategies and incorporate them into your daily activities. Use stairs not elevator, connect to support groups, the community, chew nicotine gums, use nicotine patch, eat more vegetables and fruits and more whole grains and cut down or stop alcohol consumption. ARRANGE: Let\u0026rsquo;s schedule our meetings every four weeks to discuss any challenges and to keep track of your progress. \u003csup\u003e12\u0026ndash;13\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe components of the WHO STEPS include:\u003c/p\u003e \u003cp\u003eDiet: The number of fast foods they ate, how many servings per day in a typical week, \u0026gt;\u0026thinsp;2 servings does not meet criteria\u0026thinsp;=\u0026thinsp;0, none or less than 2 met criteria\u0026thinsp;=\u0026thinsp;1. Vegetables and Fruits eating per day in a typical week: none (does not meet criteria\u0026thinsp;=\u0026thinsp;score of 0); \u0026lt; 1\u0026ndash;2 servings (does not meet criteria\u0026thinsp;=\u0026thinsp;0); \u0026gt;2 (met criteria\u0026thinsp;=\u0026thinsp;1). Carbonated drinks: Consumption of carbonated soft drinks on a usual day of the week (a) 1\u0026ndash;2 times= score of 1, \u0026gt; 2 time\u0026thinsp;=\u0026thinsp;0\u003c/p\u003e \u003cp\u003ePhysical Activity: per week for Age \u0026ge;\u0026thinsp;18years: \u0026lt; 150 minutes / week\u0026thinsp;=\u0026thinsp;0, \u0026gt; 150 minutes /week\u0026thinsp;=\u0026thinsp;1.\u003c/p\u003e \u003cp\u003eAlcohol use: yes answer (does not meet criteria\u0026thinsp;=\u0026thinsp;0), No answer (met criteria\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e \u003cp\u003eTobacco use (smoking): smoker\u0026thinsp;=\u0026thinsp;0 (b) non-smoker\u0026thinsp;=\u0026thinsp;1.\u003c/p\u003e \u003cp\u003eLifestyle practices were assessed with the Healthy behaviour score (HBS): This tool tracks the number of healthy and unhealthy lifestyle(s) of an individual. It is a well-validated tool that measures and assigns a score to lifestyle practices.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e The score ranges from 1 to 4. The score of 1 is the lowest, while four is the highest. The score of 1 and 2 indicate an inadequate (unhealthy) Lifestyle, while a score of 3 and 4 indicate adequate (healthy) lifestyle practices. Participants who did not have a functioning phone were reached through their spouses, children or close relatives (a total of two phone numbers, from the index patient and a close relative were obtained). Information leaflets on dietary education (in Hausa or English) were also given to each of them.\u003c/p\u003e \u003cp\u003eGlycated Heamoglobin (HbA1c): Measured based on the widely accepted guidelines by the American Diabetes Association (ADA), and the International Diabetes Federation (IDF), an HbA1c level of less than 7% indicated good glycaemic control, while values 7% and above was recorded as poor glycaemic control.\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eControl Arm\u003c/h3\u003e\n\u003cp\u003eEach participant in the control arm had the questionnaires administered in English and Hausa and received standard care for diabetic patients. Their blood samples were collected for HbA1c. They received neither structured lifestyle counselling nor telephone call reminders. However, they were given dietary education leaflets.\u003c/p\u003e\n\u003ch3\u003eFollow up\u003c/h3\u003e\n\u003cp\u003eThere was follow-up at the 4th week and 12th week (a total of 16 weeks) for the intervention arm only. Participants in both arms were seen at the 16th week for the post intervention follow-up, depending on their recruitment week, for re-assessment of lifestyle practices/clinical parameters. At the end of the intervention period, follow-up measurements were taken for both the intervention and control arms at the 16th week, including HbA1c, blood pressure, weight, and height (for BMI). These parameters were used to evaluate the effect of the intervention on glycaemic control and other lifestyle-related outcomes. The study adheres to and was reported according to CONSORT guidelines as depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e\u0026lt;Insert Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026gt;\u003c/h2\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eThe collected data were analysed using IBM\u0026reg; SPSS version 23. The categorical variables, such as sex, residence, marital status, occupation, wereexpressed in frequencies and percentages, while mean and standard deviation were used for continuous variables such as age, FBG, HbA1c, BMI or median and interquartile range where appropriate. Chi-square was used for the association between categorical variables and Wilcoxon signed ranked test was used to find the median decrease in glycaemic control. A p-value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eEthical Consideration\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e was obtained from the Health Research Ethics Committee of Aminu Kano Teaching Hospital (Appendix A: NHREC number 28/01/2020/AKTH/EC/3439AKTH). The study was conducted according to the Helsinki Declaration.\u003c/p\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eBaseline socio-demographic and clinical characteristics of study participants\u003c/h2\u003e \u003cp\u003eThe data of 119 participants were analysed out of the 126 participants initially recruited for the study, with an attrition rate of 6%. The majority 60 (50.4%) of the participants belonged to the middle-aged group with a mean age of 55.9\u0026thinsp;\u0026plusmn;\u0026thinsp;11.54 years. Females constituted a larger proportion of the participants 77 (64.7%), and full-time housewives 45(37.8%), was the predominant occupation. Most participants were Muslims, 116 (97.5%), urban dwellers, 101(84.9%) and had Qur\u0026rsquo;anic level of education. Majority of the study participants, 77 (64.7%) came from monogamous families. At baseline there was no statistically significant difference in sociodemographic and clinical characteristics between the intervention and control arms (Table\u0026nbsp;1and Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eBaseline comparison of clinical characteristics\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention (n\u0026thinsp;=\u0026thinsp;59)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFAMILY HISTORY OF DIABETES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAbsent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (61.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (39.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.788\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePresent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (44.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (55.1 (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.128*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.396\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal weight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (50 .0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOverweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (55.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (44.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObese\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (48.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (51.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS GLYCAEMIC CONTROL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.906\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (51.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (48.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHbA1C GLYCAEMIC CONTROL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.373\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.241\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControlled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (64.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUncontrolled\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55 (52.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50 (47.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*: Fisher\u0026rsquo;s exact test, \u003cb\u003eBold\u003c/b\u003e: Statistically significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e\u0026lt;Insert Tables\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u0026gt;\u003c/h2\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline comparison of the sociodemographic characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention (n\u0026thinsp;=\u0026thinsp;59)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;119)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAGE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYoung\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (45.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (54.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11(9.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (48.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (51.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60(50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.786\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElderly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (54.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (54.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48(40.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSEX\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (54.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (45,2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42(35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (48.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77(64.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.484\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRESIDENCE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53 (52.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (47.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e101(84.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (61.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18(15.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.288\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOCCUPATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBusiness/trading\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21(51.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20(48.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41(34.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFull time housewife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21(51.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(48.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45(37.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDriving\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2(1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.439*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.954\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4 (44.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (55.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9(7.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (57.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14(11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (62.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (37.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8(6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEMPLOYMENT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29 (49.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (50.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59(49.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31 (51.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (48.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60(50.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.784\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMARITAL STATUS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (60.0.)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5(4.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47 (54.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (46.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87(73.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (25.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (75.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4(3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.148*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.558\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (43.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23(19.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRELIGION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e116(97.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3(2.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTRIBE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHausa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39 (48.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (51.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81(68.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFulani\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (45.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (54.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24(20.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYoruba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.444\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.496\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgbo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1(0.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (69.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12(10.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEDUCATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0%))\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2(1.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQur\u0026rsquo;an\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (48.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (51.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58(48.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (53.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (46.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15(12.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.566\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.633\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (52.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (47.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21(17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (56.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (43.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23(19.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFAMILY TYPE\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonogamous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (48.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (41.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77(64.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.484\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolygamous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23(54.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(45.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42(35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eBaseline comparison of lifestyle practices\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the baseline comparison of the lifestyle practices of participants in both arms of the study. There were no significant differences in snack consumption, fruit consumption, vegetables consumption, fast-food consumption, carbonated drink consumption, physical activity levels and tobacco smoking status between the participants in the control and intervention arms of the study (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline comparison of lifestyle practices\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eIntervention (n\u0026thinsp;=\u0026thinsp;59)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNACK CONSUMPTION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.507\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (45.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (54.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (52.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (47.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFRUIT CONSUMPTION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (64.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (68.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (31.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (49.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45 (50.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVEGETABLE CONSUMPTION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.320005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.850\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1 (33.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFAST FOOD CONSUMPTION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.417*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.817\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (48.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (51.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (40.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (52.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (47.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCARBONATED DRINKS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.455*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.509\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (47.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (52.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 2 servings per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (61.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (38.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePHYSICAL ACTIVITY\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.784\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.676\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (55.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (44.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess than 150 minutes per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (47.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (52.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 150 minutes per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (56.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (44.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSMOKING\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*: Fisher\u0026rsquo;s exact test, \u003cb\u003eBold\u003c/b\u003e: Statistically significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003e\u0026lt;Insert Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026gt;\u003c/h2\u003e \u003cdiv id=\"Sec19\" class=\"Section3\"\u003e \u003ch2\u003ePre- intervention lifestyle practices with healthy behaviour score\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e show that 53.6% of participants in the control arm and 46.4% in the intervention arm were engaged in unhealthy lifestyle behaviours. Conversely, 49.5% of the control arm and 50.5% of the intervention arm had healthy lifestyle behaviours. However, these relationships were not statistically significant (\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;0.145 and p-value of 0.703).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e\u0026lt;\u0026lt;insert Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e \u0026gt;\u003c/h2\u003e \u003cdiv id=\"Sec21\" class=\"Section3\"\u003e \u003ch2\u003ePost-intervention lifestyle practices with healthy behaviour score\u003c/h2\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: Post-intervention, there was a significant difference in healthy behaviour scores between the control and intervention arms (\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;29.298, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001); suggesting clearly, that the intervention had an effect on the participants\u0026rsquo; lifestyle practices.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e\u0026lt;\u0026lt;insert Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u0026gt;\u003c/h2\u003e \u003cp\u003e \u003cb\u003ePre- and post-intervention glycaemic control.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e4\u003c/span\u003ea and \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e4\u003c/span\u003eb shows the median FBG decreased in intervention arm from 7.8mmol/L pre-intervention to FBG was 6.0 mmol/L post-intervention, also in the control arm from 7.6mmol/L to 6.5 mmol/L there was a statistically significant improvement in FBG post-intervention among both intervention (z = -4.124, p-value\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and control arm (z = -3.225, p-value\u0026thinsp;=\u0026thinsp;0.001). Similarly, the median HbA1c in the intervention arm decreased from 8.4% pre-intervention to 7.0% post-intervention, while in the control arm it decreased from 8.2% to 7.1%. Using the Wilcoxon signed-rank test, this reduction was statistically significant in both the intervention arm (z = -3.774, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and the control arm (z = -3.158, p\u0026thinsp;=\u0026thinsp;0.002\u003cb\u003e).\u003c/b\u003e However, the effect of counselling on glycaemic control was not statistically significant (\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;3.517 p\u0026thinsp;=\u0026thinsp;0.061) as depicted in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEffect of Counselling on Glycaemic control\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControlled (n\u0026thinsp;=\u0026thinsp;60)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUncontrolled (n\u0026thinsp;=\u0026thinsp;59)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eCI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFBS glycaemic control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.517*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.60\u0026ndash;1.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44 (74.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15 (25.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBA1C glycaemic control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.944\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.983\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.62\u0026ndash;1.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (36.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (63.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22 (37.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (62.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*: Fisher\u0026rsquo;s exact test, \u003cb\u003eBold\u003c/b\u003e: Statistically significant\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003e\u0026lt;\u0026lt;insert Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e4\u003c/span\u003ea and \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e4\u003c/span\u003eb\u0026gt;\u003c/h2\u003e \u003cdiv id=\"Sec24\" class=\"Section4\"\u003e \u003ch2\u003e\u0026lt;Insert Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u0026gt;\u003c/h2\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe lifestyle practices assessed in this study included physical activity, cigarette smoking, alcohol consumption, and dietary habits. The findings revealed that participants who received lifestyle modification interventions demonstrated improved knowledge, increased adoption of health-promoting behaviours, and better glycaemic control than those in the control group.\u003c/p\u003e \u003cp\u003eSimilar to our findings, Kadriye et al, in Turkey, reported a good alignment between the counselling intervention and the Information\u0026ndash;Behaviour\u0026ndash;Motivation (IBM) model utilised.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e The intervention demonstrated a statistically significant difference between the intervention and control groups.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e This may be attributed to participants effectively applying the counselling received in familiar language with repetitive telephone reminders, thereby translating knowledge into appropriate lifestyle practices.\u003c/p\u003e \u003cp\u003eSimilarly, Haque et al, in Malaysia, employed the use of weekly SMS messages to participants with various NCDs like lung cancer, obesity, metabolic syndrome, Chronic Obstructive Airway Disease COPD, Hypertension and Diabetes mellitus, as the primary counselling strategy.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e However, our study employed a structured one-on-one LSM counselling session delivered once, and three weekly reminders (5 sessions in all). Nonetheless, both studies share the common objective of promoting cost-effective lifestyle modification, highlighting the potential effectiveness of brief, engaging messages both in low-middle-income countries.\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eInversely, Marjanović et al, found that 43.3% of patients had unhealthy diets, 56.0% were physically inactive, and 26.3% were smokers and had poorly controlled glycaemia 36.8% because of poor adherence to lifestyle intervention counselling. The reason for dissimilarities could likely be related to the different lifestyle assessment tools, as we used the WHO Steps HBS composite score while they used the Perceived Stress Scale to examine stress in lifestyle behaviour.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn this study, we documented a significant decrease in median HbA1c post-intervention in both arms. However, the effect of structured counselling on glycaemic control was not statistically significant. The improvement with no statistical difference may probably be related to the duration of the study, 22 weeks, less than six months, when the effect of most intervention is observed.\u003c/p\u003e \u003cp\u003eConversely, Ibrahim et al, in Egypt, also reported that LSM counselling interventions can lead to improvements in glycaemic control and health outcomes among type-2 diabetic patients.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eIn contrast to our findings, Kumari et al, found statistically significant improvements in fasting blood glucose and HbA1c levels post-intervention. The difference may be attributed to the use of a holistic model in counselling participants, which may have provided a more comprehensive and effective approach and a longer follow-up period of 12 months.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe limitations of our study were related to duration of the intervention 22 weeks only and although the study was RCT been hospital-based limit its external validity. However, the strengths are the findings of this study suggest exploring other alternatives or adjunct interventions in the place of face-to-face LSM counselling sessions, such as telephone reminders, and mobile Apps use. These should be encouraged both in busy resource-limited and even resource-abundant settings. Further longitudinal long-term studies to assess sustained effects and investigate dose\u0026ndash;response relationships between reminders and outcomes should be considered. Implementation science research on the cost effectiveness, appropriateness, acceptability, feasibility, of technology feedback loops should also be considered.\u003c/p\u003e"},{"header":"CONCLUSION","content":" \u003cp\u003e There was a statistically significant difference between the participants who were counselled on lifestyle practices and those who were not counselled. Although there was an improvement in glycaemic control post-intervention in both arms, the difference was not statistically significant. These findings highlight the value of lifestyle counselling in diabetes care and suggest that additional or complementary strategies may be needed to enhance glycaemic outcomes. Further research with larger sample sizes and extended follow-up is recommended.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAKTH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAminu Kano Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBMI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBody Mass Index\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDiabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFBG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFasting Blood Glucose\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHbA1C\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGlycated Heamoglobin\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHBS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealthy behaviour score\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLSM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLifestyle Modification\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eRandomised Controlled Trial\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eT2DM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eType-2 Diabetes Mellitus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConsent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants signed informed written consent and ethical approval was obtained for the study from\u0026nbsp;the Health Research Ethics Committee of Aminu Kano Teaching Hospital (NHREC number 28/01/2020/AKTH/EC/3439AKTH).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publications –\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData will be available on reasonable request according to data privacy agreement of the institution.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research was fully funded by the authors. There was no external funding received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe appreciate all the participants for their time and voluntary participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;None to declare\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAAG, ZA - Research conceptualization and initial manuscript writing\u003c/p\u003e\n\u003cp\u003eZA, FMD, ALO, AKS AAY- manuscript writing and review\u003c/p\u003e\n\u003cp\u003eAAG, TTO, ALO, ZA – data collection and analysis\u003c/p\u003e\n\u003cp\u003eZA, AKS, FMD, ALO, TAB,GMC, BAG – Review figures, tables and senior advisory input\u003c/p\u003e\n\u003cp\u003eAll authors- Review manuscript and provide final approval for publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKumari G, Singh V, Jhingan AK, Dahiya S. Impact of Lifestyle Modification Counseling on Quality of Life of Type 2 Diabetes Mellitus Patients using Appraisal Scale of Diabetes. Int J Adv Sci Eng Technol. 2017;5(2):70\u0026ndash;2.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaumann F. Classification of diabetes mellitus [Internet]. World Helath Organization. 2019 [cited 2022 Jun 5]. pp. 1\u0026ndash;28. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://apps.who.int/iris/rest/bitstreams/1233344/retrieve\u003c/span\u003e\u003cspan address=\"https://apps.who.int/iris/rest/bitstreams/1233344/retrieve\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoyko EJ, Magliano DJ, Karuranga S, Piemonte L, Saeedi PRP, Sun H. IDF Diabetes Atlas [Internet]. 10th ed. International Diabetes Federation; 2021. 1\u0026ndash;141 p. Available from: www.diabetesatlas.org %7C.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim F, Megahed AL, Hassan SAA, Abdelwahid HA, Farg HK. Effect of Lifestyle Modification on Glycemic Control of Type 2 Diabetic Patients at Suez Canal University Hospitals. Intech Open. 2021;3:1\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUloko AE, Musa BM, Ramalan MA, Gezawa ID, Puepet FH, Uloko AT, et al. Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Ther. 2018;9(3):1307\u0026ndash;16.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJosh Reed, Stephen Bain VK. A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments and Future Perspecext Article REVIEW A Review of Current Trends with Type 2 Diabetes Epidemiology, Aetiology, Pathogenesis, Treatments and Future Perspect. J Diabetes metabolic Syndr obesitytargets Ther. 2021;14:3567\u0026ndash;602.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumari G, Singh V, Jhingan AK. Effectiveness of Lifestyle Modification Counseling on Glycemic Control in Type 2 Diabetes Mellitus Patients. Curr Res food Sci. 2018;06(1):70\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSalihu DA, Yohanna S. The effect of structured counselling on lifestyle modification measures among adult pre-hypertensive patients in a tertiary hospital in North Central Nigeria. Niger J Med. 2019;28:118\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVishwanath J. The Concept Behind Sample Size Calculation for Randomised Control Trials. A Review. Sci Acta Heal Nutr. 2019;3(2):90\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolarinwa OA. Sample Size Estimation for Health and Social Science Researchers: The Principles and Considerations for Different Study Designs. Natl post Grad Med J. 2020;27(2):67\u0026ndash;75.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGezawa ID, Uloko AE, Gwaram BA, Ibrahim DA, Ugwu ET, Mohammed IY. Pattern of obesity among patients with type 2 diabetes at a tertiary healthcare center in Northern Nigeria. Diabetes, Metab Syndr Obes Targets Ther. 2019;12:2785\u0026ndash;90.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eStatcan. Lifestyle practice Health Behaviour score [Internet]. Canadian health fact sheet. 2016 [cited 2023 Apr 16]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www150.statcan.gc.ca/n1/pub/82-625-x/82-625-x2017001-eng.htm\u003c/span\u003e\u003cspan address=\"https://www150.statcan.gc.ca/n1/pub/82-625-x/82-625-x2017001-eng.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. Toolkit for delivering the 5A\u0026rsquo;s and 5R \u0026rsquo;s brief tobacco interventions in primary care. World Helath Organ. 2014:1\u0026ndash;17.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMichael GC, Ehalaiye DN, Ibrahim H, Falaki FA, Suleiman AK, Grema BA, et al. Assessment of workhour feeding practices, healthy behaviour score and body mass index of physicians in Northern Nigeria: a cross-sectional multi-centre study. J Prev Med Hyg. 2024;65(1):E73\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmerican Diabetic Association Standard of Medical Care in Diabetes: Updates 2025. Acessed. 3rd June 2025 available at \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://professional.diabetes.org/standards-of-care\u003c/span\u003e\u003cspan address=\"https://professional.diabetes.org/standards-of-care\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKadriye SK, Guler DA, Cemile KY, Canlar Ş. The effect of model-based telephone counseling on HbA1c and self-management for individuals with type 2 diabetes: A randomised controlled trial. Prim Care Diabetes. 2022;16(1):41\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaque M. Lifestyle Changes in the Management of Non-Communicable Diseases in Low and Middleincome Countries. Int J Hum Heal Sci. 2020;5(1):4\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarjanović M, Đido V, Bralić Lang V, Martinović Ž, Ovčina A. The Association of Clinical Characteristics and Lifestyle Habits with Poor Glycemic Control in Patients with Type 2 Diabetes Mellitus. Eur J Med Heal Sci. 2021;3(1):79\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim F, Megahed AL, Hassan SAA, Abdelwahid HA, Farg HK. Effect of Lifestyle Modification on Glycemic Control of Type 2 Diabetic Patients at Suez Canal University Hospitals. Intech Open. 2021;3:1\u0026ndash;28.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ehttps://\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003edocs.google.com/document/d/1uMJp2wezmc5wkZTqJUFPRzMWFs7\u003c/span\u003e\u003cspan address=\"http://docs.google.com/document/d/1uMJp2wezmc5wkZTqJUFPRzMWFs7\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003exCPCo/edit?usp=drivesdk\u0026amp;ouid=106491892114506665198\u0026amp;rtpof=true\u0026amp;sd=true\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-endocrine-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bend","sideBox":"Learn more about [BMC Endocrine Disorders](http://bmcendocrdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bend/default.aspx","title":"BMC Endocrine Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Counselling, type-2 DM, glycaemic control, lifestyle practices, primary care","lastPublishedDoi":"10.21203/rs.3.rs-8658846/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8658846/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBACKGROUND\u003c/h2\u003e \u003cp\u003eOptimal glycaemic control is crucial in diabetic care as it minimizes complications. Adherence to a healthy lifestyle positively impacts diabetic care. This study aimed to investigate the effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control.\u003c/p\u003e\u003ch2\u003eMETHODS\u003c/h2\u003e \u003cp\u003eThe study was a randomised controlled trial (RCT) conducted among Type-2 Diabetes Mellitus (T2DM) patients over 22 weeks from November 2023 to April 2024. Participants were randomly assigned to either intervention or control arms by block randomization in blocks of four using a table of random numbers at a 1:1 ratio, with 63 participants in each arm. Data were collected using an adapted WHO STEPS questionnaire on sociodemographic, clinical characteristics and lifestyle practices both pre- and post-intervention. A composite Health Behaviour Score (HBS) was used for scoring. Structured counselling was conducted using the 5A\u0026rsquo;s framework, with five follow-up telephone reminders containing standard pre-recorded messages in Hausa (predominant language) and English.\u003c/p\u003e\u003ch2\u003eRESULTS\u003c/h2\u003e \u003cp\u003eThe study found a significant post‑intervention increase in healthy behaviour scores; intervention (73.8%) compared to control (26.2%). The difference was statistically significant (χ\u0026sup2; = 29.3, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), while both arms had pre-intervention comparable baseline healthy behaviour scores (χ\u0026sup2; = 0.145, p\u0026thinsp;=\u0026thinsp;0.703). The Wilcoxon signed-rank test indicated a statistically significant decrease in median HbA1c post-intervention in both arms (intervention: z = -3.774, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001; control: z = -3.158, p\u0026thinsp;=\u0026thinsp;0.002). However, the effect of counselling on glycaemic control was not statistically significant (\u0026#120536;\u003csup\u003e2\u003c/sup\u003e\u0026thinsp;=\u0026thinsp;3.517 p\u0026thinsp;=\u0026thinsp;0.061).\u003c/p\u003e\u003ch2\u003eCONCLUSION\u003c/h2\u003e \u003cp\u003eStructured lifestyle modification counselling significantly improved healthy behaviour among T2DM patients with no significant effect on glycaemic control. This suggests that counselling is effective for lifestyle change. Therefore, integrating structured lifestyle counselling with telephone reminders may serve as an innovative way to promote healthy lifestyles in the busy resource-limited primary care setting.\u003c/p\u003e\u003ch2\u003eTRIAL REGISTRATION\u003c/h2\u003e \u003cp\u003eThe trial was registered by Pan African Clinical Trial Registry (https//pactr.samrc.ac.za) with registration number PACTR202601577207835 registered on 20th January, 2026.\u003c/p\u003e","manuscriptTitle":"Effect of structured lifestyle modification counselling on lifestyle practices and glycaemic control among Type-2 Diabetes patients in northern Nigeria (SLIC-T2D trial): A Randomised Controlled Trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-02 08:43:41","doi":"10.21203/rs.3.rs-8658846/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-08T13:08:45+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-14T10:51:04+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-11T07:58:40+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-09T01:04:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"151236418128878356521300591019498480061","date":"2026-03-08T13:10:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"228594392189796456510270429943749604591","date":"2026-03-06T13:15:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"218370510138776410452555815753514209828","date":"2026-03-05T09:07:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"296258266206884452836482216875891738036","date":"2026-02-24T23:25:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-24T18:48:02+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-23T08:17:16+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-01-29T05:51:15+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-28T12:33:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Endocrine Disorders","date":"2026-01-28T11:05:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-endocrine-disorders","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bend","sideBox":"Learn more about [BMC Endocrine Disorders](http://bmcendocrdisord.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bend/default.aspx","title":"BMC Endocrine Disorders","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d4290388-1a8f-4575-83a5-8ea804b01e7e","owner":[],"postedDate":"March 2nd, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-08T13:08:45+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T13:26:17+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-02 08:43:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8658846","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8658846","identity":"rs-8658846","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}