title: The effects of adding group-based lifestyle counselling to individual counselling on changes in plasma glucose levels in a randomized controlled trial: the Inter99 study.
abstract: OBJECTIVE
  This study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes.
  
  
  METHODS
  In a population-based study of 6784 participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738 participants free of diabetes at baseline (1999-2001) and with at least one FPG and/or 2hPG measurement during 5 years of follow-up were included in the analyses. Differences in changes of plasma glucose between groups A and B were analyzed using multilevel linear regression.
  
  
  RESULTS
  For FPG, crude 5-year changes were significantly different between the two groups (group A: -0.003 mmol/L vs group B: -0.079 mmol/L; P=0.0427). After adjusting for relevant confounders, no differences in FPG changes were observed (P=0.116). Also, no significant differences in the 5-year changes in 2hPG between the two groups were observed (group A: - 0.127 mmol/L vs group B: -0.201 mmol/L; P=0.546).
  
  
  CONCLUSIONS
  Offering additional group-based intervention to a high-risk population subgroup had no clinical effects on changes in plasma glucose beyond those of individualized multifactorial interventions.
authors: Steno Diabetes Center A/S, 2820 Gentofte, Denmark. cala@steno.dk
authors: C
authors: C
authors: Lau
authors: D
authors: D
authors: Vistisen
authors: U
authors: U
authors: Toft
authors: I
authors: I
authors: Tetens
authors: C
authors: C
authors: Glümer
authors: O
authors: O
authors: Pedersen
authors: T
authors: T
authors: Jørgensen
authors: K
authors: K
authors: Borch-Johnsen
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003376:Counseling; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D004032:Diet; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects / Q000097:blood* / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D044465:White People
chemical_list: D001786:Blood Glucose