Do depressive symptoms have an impact on the effectiveness of lifestyle counseling in prevention of type 2 diabetes? One-year follow-up of FIN-D2D.
OBJECTIVE
To examine whether depressive symptoms are associated with the effectiveness of lifestyle counseling on cardio-metabolic risk profile and glucose homeostasis during one-year follow-up in individuals at high risk for type 2 diabetes (T2D).


METHODS
A total of 10,149 individuals took part in the implementation project of the national diabetes prevention program (FIN-D2D) conducted in primary health care setting in Finland. At baseline, altogether 2798 non-diabetic individuals participated in the one-year follow-up, and 2275 of them had at least one group or individual counseling visit.


RESULTS
4.0% of the individuals (n=78) had depressive symptoms, while 96.0% (n=1889) were free of depressive symptoms at baseline. Individuals who had depressive symptoms had higher body mass index and waist circumference at baseline than individuals without depressive symptoms. In terms of changes in cardio-metabolic risk profile and glucose homeostasis the effectiveness of lifestyle counseling was parallel between individuals with and without depressive symptoms during the one-year follow-up.


CONCLUSIONS
Effectiveness of lifestyle counseling did not differ between individuals with and without depressive symptoms. Individuals with depressive symptoms should not be excluded from lifestyle intervention programs.
Pirkanmaa Hospital District, Tampere, Finland. Electronic address: nina.rautio@oulu.fi.
Nina
N
Rautio
Faculty of Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland; Unit of General Practice, Oulu University Hospital, Oulu, Finland.
Jari
J
Jokelainen
Pirkanmaa Hospital District, Tampere, Finland.
Heikki
H
Oksa
Pirkanmaa Hospital District, Tampere, Finland.
Timo
T
Saaristo
Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Leena
L
Moilanen
Unit of Family Practice, Central Finland Health Care District, Jyväskylä, Finland.
Mauno
M
Vanhala
National Institute for Health and Welfare, Helsinki, Finland.
Markku
M
Peltonen
Department of Internal Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
Eeva
E
Korpi-Hyövälti
Center for Vascular Prevention, Danube-University Krems, Krems, Austria.
Jaakko
J
Tuomilehto
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland; Research Unit, Kuopio University Hospital, Kuopio, Finland.
Matti
M
Uusitupa
Faculty of Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland.
Markku
M
Timonen
Faculty of Medicine, Institute of Health Sciences, University of Oulu, Oulu, Finland; Unit of General Practice, Oulu University Hospital, Oulu, Finland.
Sirkka
S
Keinänen-Kiukaanniemi
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003376:Counseling; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D018579:Patient Selection; D011320:Primary Health Care; D011322:Primary Prevention / Q000379:methods*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D055105:Waist Circumference
D015415:Biomarkers; D001786:Blood Glucose
Cardio-metabolic risk profile; Depressive symptoms; Glucose homeostasis; Lifestyle intervention; Primary health care