title: Prevention of type 2 diabetes in a primary health care setting. Interim results from the Greater Green Triangle (GGT) Diabetes Prevention Project.
abstract: Although clinical trials have shown that lifestyle modifications reduce the risk of type 2 diabetes, translating lessons from trials to primary care remains a challenge. The aim of the study was to evaluate efficacy and feasibility of primary care-based diabetes prevention model with modest resource requirements in rural Australia. Three hundred and eleven subjects with at least a moderate risk of type 2 diabetes participated in a combined dietary and physical activity intervention. Clinical measurements and fasting blood samples were taken at the baseline and after intervention. After 3 months intervention, total (change -3.5%, p<0.001) and LDL cholesterol (-4.8%, p<0.001) plasma levels as well as body mass index (-2.5%, p<0.001), weight (-2.5%, p<0.001), and waist (-1.6%, p<0.001) and hip (-2.7%, p<0.001) circumferences reduced significantly. A borderline reduction was found in triglyceride levels (-4.8%, p=0.058) while no changes were observed in HDL cholesterol (+0.6%, p=0.525), glucose (+0.06%, p=0.386), or systolic (-0.98%, p=0.095) or diastolic (-1.06%, p=0.134) blood pressure levels. In conclusion, a lifestyle intervention improved health outcomes - especially obesity and blood lipids - in a population at high risk of developing type 2 diabetes. Our results suggest that the present model is effective and feasible to carry out in primary care settings.
authors.affiliation: Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Victoria, Australia. annamari.kilkkinen@greaterhealth.org
authors.forename: Annamari
authors.initials: A
authors.lastname: Kilkkinen
authors.forename: Sami
authors.initials: S
authors.lastname: Heistaro
authors.forename: Tiina
authors.initials: T
authors.lastname: Laatikainen
authors.forename: Edward
authors.initials: E
authors.lastname: Janus
authors.forename: Anna
authors.initials: A
authors.lastname: Chapman
authors.forename: Pilvikki
authors.initials: P
authors.lastname: Absetz
authors.forename: James
authors.initials: J
authors.lastname: Dunbar
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D001524:Behavioral Medicine; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*
chemical_list: D008078:Cholesterol, LDL; D002784:Cholesterol