Lifestyle intervention for prevention of type 2 diabetes in primary health care: one-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D).
OBJECTIVE
To investigate 1-year outcomes of a national diabetes prevention program in Finland.


METHODS
Altogether 10,149 individuals at high risk for diabetes were identified with the Finnish Diabetes Risk Score (FINDRISC; scoring ≥15 points), by a history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), cardiovascular disease, or gestational diabetes mellitus in 400 primary health care centers. One-year follow-up data were available for 2,798 participants who were nondiabetic at baseline (919 men and 1,879 women, aged 56.0 ± 9.9 and 54.0 ± 10.7 years [mean ± SD] with BMI 30.9 ± 4.6 and 31.6 ± 5.4 kg/m(2)).


RESULTS
The incidence of diabetes was 2.0 and 1.2% in men and women with normal glucose tolerance at baseline, 13.5 and 7.4% in those with IFG, and 16.1 and 11.3% in those with IGT, respectively. Altogether 17.5% of the subjects lost ≥ 5% weight with no sex difference. The relative risk of diabetes was 0.31 (95% CI 0.16-0.59) in the group who lost ≥ 5% weight, 0.72 (0.46-1.13) in the group who lost 2.5-4.9% weight, and 1.10 (0.77-1.58) in the group who gained ≥ 2.5% compared with the group who maintained weight.


CONCLUSIONS
The FIN-D2D was the first national effort to implement the prevention of diabetes in a primary health care setting. Methods for recruiting high-risk subjects were simple and easy to use. Moderate weight loss in this very high-risk group was especially effective in reducing risk of diabetes among those participating in the program.
Saaristo
Timo
T
Pirkanmaa Hospital District, Tampere, Finland.
Moilanen
Leena
L
Korpi-Hyövälti
Eeva
E
Vanhala
Mauno
M
Saltevo
Juha
J
Niskanen
Leo
L
Jokelainen
Jari
J
Peltonen
Markku
M
Oksa
Heikki
H
Tuomilehto
Jaakko
J
Uusitupa
Matti
M
Keinänen-Kiukaanniemi
Sirkka
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D005260:Female; D005387:Finland; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D055105:Waist Circumference; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
D008055:Lipids