Lifestyle Intervention for Prevention of Type 2 Diabetes in Primary Health Care: One-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D)

• Published in: Diabetes care Vol. 33; no. 10; pp. 2146 - 2151
• Main Authors: Saaristo, Timo, Moilanen, Leena, Korpi-Hyövälti, Eeva, Vanhala, Mauno, Saltevo, Juha, Niskanen, Leo, Jokelainen, Jari, Peltonen, Markku, Oksa, Heikki, Tuomilehto, Jaakko, Uusitupa, Matti, Keinänen-Kiukaanniemi, Sirkka
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.10.2010
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biological and medical sciences; blood; body mass index; Cardiovascular disease; Cardiovascular diseases; Cholesterol; Clinical medicine; Data collection; Dextrose; Diabetes; Diabetes Mellitus, Type 2; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - prevention & control; Diabetes therapy; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; fasting; Female; Finland; gender differences; gestational diabetes; Glucose; glucose tolerance; Health facilities; health services; Humans; Intervention; Life Style; lifestyle; Lipids; Lipids - blood; Male; Medical sciences; men; Mens health; Metabolic diseases; Middle Aged; Miscellaneous; Mortality; noninsulin-dependent diabetes mellitus; Original Research; physiology; Prevention; prevention & control; Primary Health Care; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; relative risk; Risk Factors; Type 2 diabetes; Waist Circumference; weight loss; Weight Loss - physiology; women; Womens health; Young Adult; Europe; Finland; Endocrinopathy; Type 2 diabetes; Human; Sanitary program; Nutrition; Primary health care; Metabolic diseases; Prevention; Surveillance; Follow up study; Endocrinology; Public health; Life style
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dc10-0410

OBJECTIVE: To investigate 1-year outcomes of a national diabetes prevention program in Finland. RESEARCH DESIGN AND METHODS: Altogether 10,149 individuals at high risk for diabetes were identified with the Finnish Diabetes Risk Score (FINDRISC; scoring ≥15 points), by a history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), cardiovascular disease, or gestational diabetes mellitus in 400 primary health care centers. One-year follow-up data were available for 2,798 participants who were nondiabetic at baseline (919 men and 1,879 women, aged 56.0 ± 9.9 and 54.0 ± 10.7 years [mean ± SD] with BMI 30.9 ± 4.6 and 31.6 ± 5.4 kg/m²). RESULTS: The incidence of diabetes was 2.0 and 1.2% in men and women with normal glucose tolerance at baseline, 13.5 and 7.4% in those with IFG, and 16.1 and 11.3% in those with IGT, respectively. Altogether 17.5% of the subjects lost ≥5% weight with no sex difference. The relative risk of diabetes was 0.31 (95% CI 0.16-0.59) in the group who lost ≥5% weight, 0.72 (0.46-1.13) in the group who lost 2.5-4.9% weight, and 1.10 (0.77-1.58) in the group who gained ≥2.5% compared with the group who maintained weight. CONCLUSIONS: The FIN-D2D was the first national effort to implement the prevention of diabetes in a primary health care setting. Methods for recruiting high-risk subjects were simple and easy to use. Moderate weight loss in this very high-risk group was especially effective in reducing risk of diabetes among those participating in the program.