Diabetes Prevention Program with or without Hunger Training in Helping to Lower Breast Cancer Risk in Obese Participants

Inclusion Criteria

• Body Mass Index (BMI) >= 27 kg/m^2.
• At high risk of developing breast cancer defined by one or more of the following: Gail model lifetime risk > 20% or a 5 year risk >1.66%, a history of deleterious BRCA1/2 mutation or mantle radiation, a history of ductal cancer in situ, or a history of high risk premalignant breast lesion.
• 12 months without a period/menstrual cycle or having had a bilateral oophorectomy.
• Ability to take digital time stamped photos.
• Internet access (daily).
• Reports being proficient in English (can read/write and speak fluently).

Exclusion Criteria

• Previous participation in this trial. Participation is defined as screening. Re-screening is not allowed except for individuals excluded for BMI. Patients previous screened as ineligible due to BMI are allowed to be re-screened and enrolled if eligible.
• Has a current measured BMI less than 27 kg/m^2.
• Reports being unwilling to use Continuous Glucose Monitor (CGM), which requires daily blood sampling by finger pricks.
• Currently being actively treated for cancer other than nonmelanoma skin cancer.
• Known inability to participate in the ongoing appointments for the four months of the study and scheduled follow-up tests.
• Reported current diagnosis or history of type I diabetes or type 2 diabetes.
• Reported use of oral antidiabetic agents (OADs).
• Current use of any drug (except metformin) or anticipated change in concomitant medication, which the investigator’s opinion could interfere with the glucose metabolism (e.g. systemic corticosteroids).
• Previous or current treatment with any insulin regimen other than basal insulin, e.g. prandial or pre-mixed insulin (short term treatment due to intercurrent illness including gestational is allowed at the discretion for the investigator).
• Previous or current treatment with GLP-1 receptor agonists (e.g. exenatide, liraglutide).
• Fasting blood glucose level > 126 and glycosylated hemoglobin (HbA1c) > 7%.
• Subjects considered by the investigator as unsuitable for the study for reasons not otherwise stated.