The effectiveness of a community-based, type 2 diabetes prevention programme on health-related quality of life. The DE-PLAN study

• Published in: PloS one Vol. 14; no. 10; p. e0221467
• Main Authors: Karamanakos, Georgios, Costa-Pinel, Bernardo, Gilis-Januszewska, Aleksandra, Velickiene, Dzilda, Barrio-Torrell, Francisco, Cos-Claramunt, Xavier, Mestre-Miravet, Santiago, Piwońska-Solska, Beata, Hubalewska-Dydejczyk, Alicja, Tuomilehto, Jaakko, Liatis, Stavros, Makrilakis, Konstantinos
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11.10.2019; Public Library of Science (PLoS)
• Subjects: Aged; Analysis; Anthropometry; Biology and Life Sciences; Chronic illnesses; Clinical trials; Development and progression; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - prevention & control; Disease control; Disease prevention; Endocrinology; Exercise; Female; Females; Glucose; Glucose tolerance; Glucose tolerance test; Health aspects; Health care; Health risks; Hospitals; Humans; Intervention; Lifestyles; Lipids; Male; Medicine and Health Sciences; Middle Aged; Mortality; Multivariate analysis; Prevention; Prevention programs; Preventive medicine; Primary care; Public Health; Quality assessment; Quality of Life; Questionnaires; Research and Analysis Methods; Risk Reduction Behavior; Studies; Surveys and Questionnaires; Systematic review; Type 2 diabetes; Weight control; Weight reduction; Greece; Poland; Finland; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0221467

The DE-PLAN was a European multicenter study, with the primary objective of testing whether a community-based lifestyle modification programme could serve as a means of primary prevention for type 2 diabetes (T2D) in high-risk individuals (based on the FINDRISC questionnaire). The aim of this study was to examine the impact of a 1-year community-based lifestyle intervention on health-related quality of life (HRQOL) in individuals from four participating European centers (Athens, Barcelona, Krakow, Kaunas), through a post-hoc analysis. Each center was allowed to implement different intervention strategies specifically tailored to the needs of their corresponding population sample. Before and after the intervention, participants underwent clinical evaluation, anthropometric measurements, an oral glucose tolerance test and lipid profile measurements. Health-related quality of life was assessed using the validated HRQOL-15D questionnaire. A difference of ±0.015 in the 15D questionnaire score was set as the threshold of clinically meaningful change. Data from 786 participants (67% females, mean age 59.7±9.4 years, BMI 31.5±4.5 kg/m2) with complete data regarding the HRQOL were analyzed (Athens: 104, Barcelona: 434, Krakow: 175, Kaunas: 70). After 1 year, a significant overall improvement in HRQOL was shown, as depicted by a change of 15D score from baseline value (0.88±0.9) to post-intervention (0.90±0.87, P<0.001), achieving the threshold of clinically meaningful change. A significant weight reduction was also observed (-0.8±4.0 kg, P<0.001). In multivariate analysis, improvement in HRQOL was independently associated with lower 15D score at baseline (P<0.001) and self-reported increase in overall exercise time (P<0.001) as assessed through specifically designed trial questionnaires. A community-based lifestyle intervention programme aiming at T2D prevention, applied on a heterogeneous population and with varied methods, was shown to improve overall health-related quality of life to a clinically meaningful degree.