title: DELIGHT (delay of impaired glucose tolerance by a healthy lifestyle trial) - a feasibility study on implementing a program of sustainable diabetes prevention in German companies.
abstract: BACKGROUND
  Ca. 50% of Germans develop prediabetes in their lifetime. Though diabetes type 2 has been proven preventable, no screening for prediabetes has been implemented. DELIGHT was designed to assess if screening for individuals at risk and long-standing diabetes prevention is feasible in the setting of companies within the scope of the German legal health system.
  
  
  METHODS
  In 5 companies employees with a waist circumference of ≥ 94 (men) and ≥ 80 cm (women) were offered a check-up. Those with fasting plasma glucose ≥ 100 mg/dl (IFG) or ≥ 140 mg/dl 2 h after oral glucose load (IGT) were followed for 3 years with an optional moderate lifestyle program during the first year and quarterly assistance for another 2 years.
  
  
  RESULTS
  In 241 of 300 participants the self-measured waist circumference was confirmed as elevated. 3% had type 2 diabetes, while 37% had IFG (isolated in 96%) or IGT, of whom 91.4% (men) and 76.1% (women) had a metabolic syndrome. Within 3 years in those who had lost ≥ 1 kg, weight was reduced by 3.9 kg, risk factors were improved, and no case of diabetes had developed, while among those with weight loss of < 1 kg or weight gain, 10% of men and 5% of women had developed diabetes type 2. Screening for prediabetes did not increase the number or costs of drug prescriptions.
  
  
  CONCLUSIONS
  Companies provide a suitable setting for screening for prediabetes. Long-term diabetes prevention is successfully feasible within the narrow financial frame of a legal insurance system without rise of costs.
authors.affiliation: Endocrionology and Metabolism of Aging, University Hospital Hamburg-Eppendorf.
authors.forename: B-C
authors.initials: BC
authors.lastname: Zyriax
authors.affiliation: AOK NordWest, Kiel.
authors.forename: B
authors.initials: B
authors.lastname: Letsch
authors.affiliation: Cologne Institute for Health Economics and Clinical Epidemiology, The University Hospital of Cologne.
authors.forename: S
authors.initials: S
authors.lastname: Stock
authors.affiliation: Endocrionology and Metabolism of Aging, University Hospital Hamburg-Eppendorf.
authors.forename: E
authors.initials: E
authors.lastname: Windler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D018149:Glucose Intolerance / Q000453:epidemiology / Q000517:prevention & control*; D006284:Health Plan Implementation; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D017149:Private Sector; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D055105:Waist Circumference; D015431:Weight Loss; D061217:Weight Reduction Programs; D055815:Young Adult