Vantage analyzer

All outcome measures were taken at baseline, 3 months, and 12 months. The primary outcome was change in HbA_1c level measured using a DCA (Diabetes Care Analyzer) Vantage Analyzer (Siemens Healthcare Diagnostics) calibrated every 2 weeks. Disposable lancets were used to obtain the sample. The secondary outcome was change in body weight measured (barefoot while wearing light clothing) at each clinic visit on calibrated digital scales in the fasted state (minimum, 8 hours). Body composition was measured by dual-energy x-ray absorptiometry (Lunar iDXA, Getz Healthcare) by a licensed radiation technician. Exploratory outcomes included daily step count, which was monitored via a waistband pedometer (G-sensor, Pocket Pedometer, Walking With Attitude). Participants were encouraged to increase their step count by 2000 from baseline in line with the recommendation of small changes to achieve weight loss.^{16 (link)} Participants attended each clinic visit at similar times after at least 1 habitual eating day to match the baseline. Blood samples were obtained to measure fasting glucose and lipid levels, frozen at –80°C, and analyzed at the end of the intervention using Konelab analysis (Konelab 20XTi, Thermo Electron Corporation) at the University of South Australia.