title: Reduction in incidence of type 2 diabetes by lifestyle intervention in a middle eastern community.
abstract: BACKGROUND
  Very few studies have used community-based interventions for primary prevention of Type 2 diabetes, and the direct effect of such interventions on diabetes incidence is relatively unknown.
  
  
  OBJECTIVE
  This study aims to assess the effect of lifestyle modification on risk factors for noncommunicable diseases (NCDs) and the development of Type 2 diabetes at the community level.
  
  
  METHODS
  A cluster-controlled trial was conducted.
  
  
  METHODS
  In all, 3098 and 5114 individuals in intervention and control groups, respectively (mean age=43 years), recruited from District 13 of Tehran, Iran, participated in the baseline examination in 1999-2001. Among these individuals, a total of 1754 and 2993 individuals in the intervention and control groups, respectively (58%), completed a follow-up examination in 2002-2005.
  
  
  METHODS
  The study intervention involved improvement in diet, increase in the level of physical activity, and reduction in cigarette smoking through educational interviews, lectures, and publications.
  
  
  METHODS
  Incident Type 2 diabetes was measured by fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) and change in NCD risk factors.
  
  
  RESULTS
  The mean follow-up time was 3.6 years. The incidence of diabetes in the control and intervention groups was 12.2 and 8.2 per 1000 person-years, respectively, with a relative risk reduction of 65% (95% CI=30%, 83%, p<0.003). The adjusted difference in mean change of risk factors between the intervention and control groups was significant for weight (-0.5 kg in men); BMI (-0.18 kg/m(2) in men); waist circumference (-1.0 cm in women); systolic and diastolic blood pressure (-1.1 and -0.6 mmHg, respectively, in women); FPG (-2.1 and -2.3 mg/dL in men and women); 2hPG (-4.6 mg/dL in women); total cholesterol (-2.8 mg/dL in women); triglycerides (-7.6 and -5.2 mg/dL in men and women); and high-density lipoprotein cholesterol (1.1 mg/dL in women; all p<0.05).
  
  
  CONCLUSIONS
  Lifestyle intervention resulted in a significant decrease in the incidence of Type 2 diabetes and better control of NCD risk factors in a population-based setting. ISRCTN TRIAL REGISTRATION #: ISRCTN52588395.
authors.affiliation: Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Harati
authors.forename: Farzad
authors.initials: F
authors.lastname: Hadaegh
authors.forename: Amir Abbas
authors.initials: AA
authors.lastname: Momenan
authors.forename: Laleh
authors.initials: L
authors.lastname: Ghanei
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Bozorgmanesh
authors.forename: Arash
authors.initials: A
authors.lastname: Ghanbarian
authors.forename: Parvin
authors.initials: P
authors.lastname: Mirmiran
authors.forename: Fereidoun
authors.initials: F
authors.lastname: Azizi
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012737:Sex Factors; D016540:Smoking Cessation / Q000379:methods
chemical_list: D001786:Blood Glucose