Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care

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Rintamäki , R , Rautio , N , Peltonen , M , Jokelainen , J , Keinänen-Kiukaanniemi , S , Oksa , H , Saaristo , T , Puolijoki , H , Saltevo , J , Tuomilehto , J , Uusitupa , M & Moilanen , L 2021 , ' Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care ' , Primary Care Diabetes , vol. 15 , no. 3 , pp. 444-450 . https://doi.org/10.1016/j.pcd.2021.03.002

Title: Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care
Author: Rintamäki, Reeta; Rautio, Nina; Peltonen, Markku; Jokelainen, Jari; Keinänen-Kiukaanniemi, Sirkka; Oksa, Heikki; Saaristo, Timo; Puolijoki, Hannu; Saltevo, Juha; Tuomilehto, Jaakko; Uusitupa, Matti; Moilanen, Leena
Contributor: University of Helsinki, Clinicum
Date: 2021-06
Language: eng
Number of pages: 7
Belongs to series: Primary Care Diabetes
ISSN: 1751-9918
URI: http://hdl.handle.net/10138/332982
Abstract: Aims: The Finnish National Diabetes Prevention Program (FIN-D2D) was the first large-scale diabetes prevention program in a primary health care setting in the world. The risk reduction of type 2 diabetes was 69% after one-year intervention in high-risk individuals who were able to lose 5% of their weight. We investigated long-term effects of one-year weight change on the incidence of type 2 diabetes, cardiovascular events, and all-cause mortality. Methods: A total of 10,149 high-risk individuals for type 2 diabetes were identified in primary health care centers and they were offered lifestyle intervention to prevent diabetes. Of these individuals who participated in the baseline screening, 8353 had an oral glucose tolerance test (OGTT). Complete followup data during one-year intervention were available for 2730 individuals and those were included in the follow-up analysis. The long-term outcome events were collected from national health registers after the median follow-up of 7.4 years. Results: Among individuals who lost weight 2.5 & minus;4.9% and 5% or more during the first year, the hazard ratio for the incidence of drug-treated diabetes was 0.63 (95% CI 0.49 & minus;0.81, p = 0.0001), and 0.71 (95% CI 0.56 & minus;0.90, p = 0.004), respectively, compared with those with stable weight. There were no significant differences in cardiovascular events or all-cause mortality among study participants according to oneyear weight changes. Conclusions: High-risk individuals for type 2 diabetes who achieved a moderate weight loss by one-year lifestyle counseling in primary health care had a long-term reduction in the incidence of drug-treated type 2 diabetes. The observed moderate weight loss was not associated with a reduction in cardiovascular events. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of Primary Care Diabetes Europe. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Subject: Type 2 diabetes
Prevention
Primary care
Follow-up
Cardiovascular events
Mortality
IMPAIRED GLUCOSE-TOLERANCE
FOLLOW-UP
WEIGHT-LOSS
PROGRAM
MORTALITY
PROGRESSION
OVERWEIGHT
REDUCTION
METFORMIN
SETTINGS
3142 Public health care science, environmental and occupational health
3121 General medicine, internal medicine and other clinical medicine
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