Implementation and effectiveness of the first community lifestyle intervention programme to prevent Type 2 diabetes in Greece. The DE-PLAN study.
OBJECTIVE
To report our experience of implementing the first community-based lifestyle intervention programme to detect high-risk individuals and prevent the development of Type 2 diabetes mellitus (T2DM) in a general population sample in Athens, Greece (the DE-PLAN Study).


METHODS
The Finnish Type 2 Diabetes Risk Score (FINDRISC) questionnaire was distributed to 7900 people at workplaces and primary-care centres. High-risk individuals were invited to receive an oral glucose tolerance test (OGTT) and, after excluding persons with diabetes, to participate in a 1-year intervention programme, based on bimonthly sessions with a dietitian.


RESULTS
Three thousand, two hundred and forty questionnaires were returned; 620 high-risk individuals were identified and 191 agreed to participate. Recruitment from workplaces was the most successful strategy for identifying high-risk persons, enrolling and maintaining them throughout the study. The 125 participants who fully completed the programme (66 did not return for a second OGTT) lost on average 1.0+/-4.7 kg (P=0.022). Higher adherence to the intervention sessions resulted in more significant weight loss (1.1+/-4.8 vs. 0.6+/-4.6 kg for low adherence). Persons with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at baseline lost more weight than those with normal glucose tolerance (1.5+/-4.8 vs. -0.2+/-4.5 kg). The percentage of people with any type of dysglycaemia (IFG/IGT) was lower after the intervention (68.0% at baseline vs. 53.6% 1 year later, P=0.009); 5.6% developed diabetes.


CONCLUSIONS
The implementation of a lifestyle intervention programme to prevent T2DM in the community is practical and feasible, accompanied by favourable lifestyle changes. Recruitment from workplaces was the most successful strategy.
First Department of Propaedeutic Medicine, Athens University Medical School, Laiko General Hospital, Athens, Greece. kmakrila@med.uoa.gr
K
K
Makrilakis
S
S
Liatis
S
S
Grammatikou
D
D
Perrea
N
N
Katsilambros
D000328:Adult; D000368:Aged; D003153:Community Health Services / Q000458:organization & administration*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D006115:Greece; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*; D011320:Primary Health Care; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D015431:Weight Loss; D017132:Workplace