National type 2 diabetes prevention programme in Finland: FIN-D2D.
OBJECTIVE
Current evidence shows that type 2 diabetes (T2D) can be prevented by life-style changes and medication. To meet the menacing diabetes epidemic, there is an urgent need to translate the scientific evidence regarding prevention of T2D into daily clinical practice and public health. In Finland, a national programme for the prevention of T2D has been launched. The programme comprises 3 concurrent strategies for prevention: the population strategy, the high-risk strategy and the strategy of early diagnosis and management. The article describes the implementation strategy for the prevention programme for T2D.


METHODS
The implementation project, FIN-D2D, is being conducted in 5 hospital districts, covering a population of 1.5 million, during the years 2003-2007. The main actors in the FIN-D2D are primary and occupational health care providers.


RESULTS
The goals of the project are (1) to reduce the incidence and prevalence of T2D and prevalence of cardiovascular risk factor levels; (2) to identify individuals who are unaware of their T2D; (3) to generate regional and local models and programmes for the prevention of T2D; (4) to evaluate the effectiveness, feasibility and costs of the programme; and (5) to increase the awareness of T2D and its risk factors in the population and to support the population strategy of the diabetes prevention programme. The feasibility, effectiveness and costs of the programme will be evaluated according to a specific evaluation plan.


CONCLUSIONS
Current research evidence shows that the type 2 diabetes can be effectively prevented in high-risk subjects by life-style changes, which include increased physical activity and weight reduction. FIN-D2D explores ways to implement these methods on a national level.
Saaristo
Timo
T
Finnish Diabetes Association, Tampere, Finland. timo.saaristo@diabetes.fi
Peltonen
Markku
M
Keinänen-Kiukaanniemi
Sirkka
S
Vanhala
Mauno
M
Saltevo
Juha
J
Niskanen
Leo
L
Oksa
Heikki
H
Korpi-Hyövälti
Eeva
E
Tuomilehto
Jaakko
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D003927:Diet, Diabetic; D042241:Early Diagnosis; D015444:Exercise / Q000502:physiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D015438:Health Behavior; D006284:Health Plan Implementation; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration*; D009786:Occupational Health Services / Q000458:organization & administration*; D015995:Prevalence; D011314:Preventive Health Services / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D015397:Program Evaluation; D018570:Risk Assessment