title: Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: results from a randomized clinical trial.
abstract: Type 2 diabetes mellitus is increasing worldwide largely as a result from increasing obesity and sedentary lifestyle. The Finnish Diabetes Prevention Study (DPS) is the first individually randomized controlled clinical trial to test the feasibility and efficacy of lifestyle modification in high-risk subjects. We randomly assigned 522 (172 men, 350 women) middle-aged (mean age 55 yr), overweight (mean body mass index 31 kg/m(2)) subjects with impaired glucose tolerance either to the lifestyle intervention or control group. Each subject in the intervention group received individualized counseling aimed at reducing weight and intake of total and saturated fat, and increasing intake of fiber and physical activity. An oral glucose tolerance test was performed annually to detect incident cases of diabetes and to measure changes in metabolic parameters. The mean (+/- SD) weight reduction from baseline to year 1 and to year 2, respectively, was 4.2 +/- 5.1 kg and 3.5 +/- 5.5 in the intervention group and 0.8 +/- 3.7 kg and 0.8 +/- 4.4 in the control group (P < 0.001 between the groups). At the time of first analysis of the outcome data the mean duration of follow-up was 3.2 yr. The risk of diabetes was reduced by 58% (P < 0.001) in the intervention group compared with the control group. The reduction in the incidence of diabetes was directly associated with number and magnitude of lifestyle changes made. In conclusion, the DPS is the first controlled trial demonstrating that type 2 diabetes can be prevented by changes in lifestyle in high-risk subjects.
authors.affiliation: National Public Health Institute, Department of Epidemiology, Diabetes and Genetic Epidemiology Unit, Helsinki, Finland.
authors.forename: Jaana
authors.initials: J
authors.lastname: Lindström
authors.forename: Johan G
authors.initials: JG
authors.lastname: Eriksson
authors.forename: Timo T
authors.initials: TT
authors.lastname: Valle
authors.forename: Sirkka
authors.initials: S
authors.lastname: Aunola
authors.forename: Zygimantas
authors.initials: Z
authors.lastname: Cepaitis
authors.forename: Martti
authors.initials: M
authors.lastname: Hakumäki
authors.forename: Helena
authors.initials: H
authors.lastname: Hämäläinen
authors.forename: Pirjo
authors.initials: P
authors.lastname: Ilanne-Parikka
authors.forename: Sirkka
authors.initials: S
authors.lastname: Keinänen-Kiukaanniemi
authors.forename: Mauri
authors.initials: M
authors.lastname: Laakso
authors.forename: Anne
authors.initials: A
authors.lastname: Louheranta
authors.forename: Marjo
authors.initials: M
authors.lastname: Mannelin
authors.forename: Vesa
authors.initials: V
authors.lastname: Martikkala
authors.forename: Vladislav
authors.initials: V
authors.lastname: Moltchanov
authors.forename: Merja
authors.initials: M
authors.lastname: Rastas
authors.forename: Virpi
authors.initials: V
authors.lastname: Salminen
authors.forename: Jouko
authors.initials: J
authors.lastname: Sundvall
authors.forename: Matti
authors.initials: M
authors.lastname: Uusitupa
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D000328:Adult; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control* / Q000628:therapy; D004032:Diet; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss