Reducing the risk of type 2 diabetes with nutrition and physical activity - efficacy and implementation of lifestyle interventions in Finland.
BACKGROUND
The prevalence of type 2 diabetes has been increasing in Finland, in parallel with a gradual increase in overweight and obesity during the past decades. The expanding prevalence of type 2 diabetes brings along complications, most importantly CVD. Therefore, it is extremely important to implement activities to prevent type 2 diabetes.


OBJECTIVE
In the present paper, the clinical evidence for the prevention of type 2 diabetes is presented with the Finnish diabetes prevention study. In addition, the paper discusses the practical implementation of prevention of type 2 diabetes using three different types of prevention programmes as examples: FIN-D2D, including risk-screening and repeated consultation in primary health-care; FINNAIR, a workplace-targeted intervention project involving airline employees; and the good ageing in Lahti region (GOAL) programme, a community-based prevention programme.


CONCLUSIONS
FIN-D2D, the FINNAIR project and the GOAL programme have shown that screening for type 2 diabetes risk and implementing large-scale lifestyle intervention in primary health-care are feasible. However, the crucial questions still are whether it is possible to replicate the results concerning effectiveness of lifestyle intervention in primary and occupational health-care systems. Furthermore, it remains to be shown whether it is possible to achieve the same results in different health-care settings, cultures, regions and age groups, especially in adolescents and young adults among whom the increase in the incidence has been the highest. In addition, the importance of co-operation among all sections of society, citizens' awareness of healthy lifestyles and the social inequalities in health must be emphasised because the diabetes epidemic cannot be solved only by concentrating on preventive actions carried out by health-care systems.
National Institute for Health and Welfare, Diabetes Prevention Unit, PO Box 30, FI-00271 Helsinki, Finland. jaana.lindstrom@thl.fi
Jaana
J
Lindström
Pilvikki
P
Absetz
Katri
K
Hemiö
Päivi
P
Peltomäki
Markku
M
Peltonen
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003153:Community Health Services; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D004032:Diet; D004651:Employment; D015444:Exercise; D005260:Female; D005387:Finland; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008403:Mass Screening; D011320:Primary Health Care; D015397:Program Evaluation; D012307:Risk Factors; D012572:School Health Services; D016896:Treatment Outcome; D017132:Workplace; D055815:Young Adult