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

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dc.contributor.author Rintamäki, Reeta
dc.contributor.author Rautio, Nina
dc.contributor.author Peltonen, Markku
dc.contributor.author Jokelainen, Jari
dc.contributor.author Keinänen-Kiukaanniemi, Sirkka
dc.contributor.author Oksa, Heikki
dc.contributor.author Saaristo, Timo
dc.contributor.author Puolijoki, Hannu
dc.contributor.author Saltevo, Juha
dc.contributor.author Tuomilehto, Jaakko
dc.contributor.author Uusitupa, Matti
dc.contributor.author Moilanen, Leena
dc.date.accessioned 2021-08-10T06:42:01Z
dc.date.available 2021-08-10T06:42:01Z
dc.date.issued 2021-06
dc.identifier.citation 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
dc.identifier.other PURE: 167344126
dc.identifier.other PURE UUID: 10408475-2c7d-412c-b877-1ba336741aa5
dc.identifier.other WOS: 000651379500006
dc.identifier.uri http://hdl.handle.net/10138/332982
dc.description.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/). en
dc.format.extent 7
dc.language.iso eng
dc.relation.ispartof Primary Care Diabetes
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject Type 2 diabetes
dc.subject Prevention
dc.subject Primary care
dc.subject Follow-up
dc.subject Cardiovascular events
dc.subject Mortality
dc.subject IMPAIRED GLUCOSE-TOLERANCE
dc.subject FOLLOW-UP
dc.subject WEIGHT-LOSS
dc.subject PROGRAM
dc.subject MORTALITY
dc.subject PROGRESSION
dc.subject OVERWEIGHT
dc.subject REDUCTION
dc.subject METFORMIN
dc.subject SETTINGS
dc.subject 3142 Public health care science, environmental and occupational health
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.title Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care en
dc.type Article
dc.contributor.organization Clinicum
dc.contributor.organization Department of Public Health
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1016/j.pcd.2021.03.002
dc.relation.issn 1751-9918
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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