Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care
•Lifestyle intervention to prevent diabetes in primary health care was effective in long-term follow-up.•Modest weight loss substantially reduced the incidence of type 2 diabetes.•Weight reduction was not associated with a reduction in major cardiovascular events. The Finnish National Diabetes Preve...
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| Veröffentlicht in: | Primary care diabetes 2021-06, Vol.15 (3), p.444-450 |
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| creator | 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 |
| description | •Lifestyle intervention to prevent diabetes in primary health care was effective in long-term follow-up.•Modest weight loss substantially reduced the incidence of type 2 diabetes.•Weight reduction was not associated with a reduction in major cardiovascular events.
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.
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 follow-up 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.
Among individuals who lost weight 2.5−4.9% and 5% or more during the first year, the hazard ratio for the incidence of drug-treated diabetes was 0.63 (95% CI 0.49−0.81, p = 0.0001), and 0.71 (95% CI 0.56−0.90, 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 one-year weight changes.
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. |
| doi_str_mv | 10.1016/j.pcd.2021.03.002 |
| format | Article |
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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.
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 follow-up 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.
Among individuals who lost weight 2.5−4.9% and 5% or more during the first year, the hazard ratio for the incidence of drug-treated diabetes was 0.63 (95% CI 0.49−0.81, p = 0.0001), and 0.71 (95% CI 0.56−0.90, 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 one-year weight changes.
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.</description><identifier>ISSN: 1751-9918</identifier><identifier>EISSN: 1878-0210</identifier><identifier>DOI: 10.1016/j.pcd.2021.03.002</identifier><identifier>PMID: 33771515</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Cardiovascular events ; Follow-up ; Mortality ; Prevention ; Primary care ; Type 2 diabetes</subject><ispartof>Primary care diabetes, 2021-06, Vol.15 (3), p.444-450</ispartof><rights>2021 The Authors</rights><rights>Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-969c9d8497c5637852300d42b4765c54585ea491c8fab0f170d78381449e9e273</citedby><cites>FETCH-LOGICAL-c462t-969c9d8497c5637852300d42b4765c54585ea491c8fab0f170d78381449e9e273</cites><orcidid>0000-0002-3767-4223 ; 0000-0003-4678-5555</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1751991821000425$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33771515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rintamäki, Reeta</creatorcontrib><creatorcontrib>Rautio, Nina</creatorcontrib><creatorcontrib>Peltonen, Markku</creatorcontrib><creatorcontrib>Jokelainen, Jari</creatorcontrib><creatorcontrib>Keinänen-Kiukaanniemi, Sirkka</creatorcontrib><creatorcontrib>Oksa, Heikki</creatorcontrib><creatorcontrib>Saaristo, Timo</creatorcontrib><creatorcontrib>Puolijoki, Hannu</creatorcontrib><creatorcontrib>Saltevo, Juha</creatorcontrib><creatorcontrib>Tuomilehto, Jaakko</creatorcontrib><creatorcontrib>Uusitupa, Matti</creatorcontrib><creatorcontrib>Moilanen, Leena</creatorcontrib><title>Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care</title><title>Primary care diabetes</title><addtitle>Prim Care Diabetes</addtitle><description>•Lifestyle intervention to prevent diabetes in primary health care was effective in long-term follow-up.•Modest weight loss substantially reduced the incidence of type 2 diabetes.•Weight reduction was not associated with a reduction in major cardiovascular events.
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.
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 follow-up 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.
Among individuals who lost weight 2.5−4.9% and 5% or more during the first year, the hazard ratio for the incidence of drug-treated diabetes was 0.63 (95% CI 0.49−0.81, p = 0.0001), and 0.71 (95% CI 0.56−0.90, 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 one-year weight changes.
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.</description><subject>Cardiovascular events</subject><subject>Follow-up</subject><subject>Mortality</subject><subject>Prevention</subject><subject>Primary care</subject><subject>Type 2 diabetes</subject><issn>1751-9918</issn><issn>1878-0210</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kD9v2zAQxYkiQZMm_QBdAo5dpPCPKJLoVBhtGsBAl2YmaOoU05VEhaQM-NuHrp2OmY53fO_h7ofQF0pqSmh7v6tn19WMMFoTXhPCPqBrqqSqyoRclLcUtNKaqiv0KaUdIS3lSn5EV5xLSQUV12hZh-m5yhBHHJbswggJhx4PvoeUDwNgP5XPPUzZhwnngOcIxw7nwwyY4c7bDeRi8hOeIczFYTPe-uctjj79_TeOfrTxgLdgh7zFzka4RZe9HRJ8Ptcb9PTzx5_Vr2r9--Fx9X1duaZludKtdrpTjZZOtFwqwTghXcM2jWyFE41QAmyjqVO93ZCeStJJxRVtGg0amOQ36Ospd47hZSkXmdEnB8NgJwhLMkyQlkmldVuk9CR1MaQUoTfnvQ0l5kjb7EyhbY60DeGm0C6eu3P8shmh--94w1sE304CKEfuPUSTnIfJQecjuGy64N-JfwWqxo-f</recordid><startdate>202106</startdate><enddate>202106</enddate><creator>Rintamäki, Reeta</creator><creator>Rautio, Nina</creator><creator>Peltonen, Markku</creator><creator>Jokelainen, Jari</creator><creator>Keinänen-Kiukaanniemi, Sirkka</creator><creator>Oksa, Heikki</creator><creator>Saaristo, Timo</creator><creator>Puolijoki, Hannu</creator><creator>Saltevo, Juha</creator><creator>Tuomilehto, Jaakko</creator><creator>Uusitupa, Matti</creator><creator>Moilanen, Leena</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3767-4223</orcidid><orcidid>https://orcid.org/0000-0003-4678-5555</orcidid></search><sort><creationdate>202106</creationdate><title>Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care</title><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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-969c9d8497c5637852300d42b4765c54585ea491c8fab0f170d78381449e9e273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Cardiovascular events</topic><topic>Follow-up</topic><topic>Mortality</topic><topic>Prevention</topic><topic>Primary care</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rintamäki, Reeta</creatorcontrib><creatorcontrib>Rautio, Nina</creatorcontrib><creatorcontrib>Peltonen, Markku</creatorcontrib><creatorcontrib>Jokelainen, Jari</creatorcontrib><creatorcontrib>Keinänen-Kiukaanniemi, Sirkka</creatorcontrib><creatorcontrib>Oksa, Heikki</creatorcontrib><creatorcontrib>Saaristo, Timo</creatorcontrib><creatorcontrib>Puolijoki, Hannu</creatorcontrib><creatorcontrib>Saltevo, Juha</creatorcontrib><creatorcontrib>Tuomilehto, Jaakko</creatorcontrib><creatorcontrib>Uusitupa, Matti</creatorcontrib><creatorcontrib>Moilanen, Leena</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Primary care diabetes</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rintamäki, Reeta</au><au>Rautio, Nina</au><au>Peltonen, Markku</au><au>Jokelainen, Jari</au><au>Keinänen-Kiukaanniemi, Sirkka</au><au>Oksa, Heikki</au><au>Saaristo, Timo</au><au>Puolijoki, Hannu</au><au>Saltevo, Juha</au><au>Tuomilehto, Jaakko</au><au>Uusitupa, Matti</au><au>Moilanen, Leena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care</atitle><jtitle>Primary care diabetes</jtitle><addtitle>Prim Care Diabetes</addtitle><date>2021-06</date><risdate>2021</risdate><volume>15</volume><issue>3</issue><spage>444</spage><epage>450</epage><pages>444-450</pages><issn>1751-9918</issn><eissn>1878-0210</eissn><abstract>•Lifestyle intervention to prevent diabetes in primary health care was effective in long-term follow-up.•Modest weight loss substantially reduced the incidence of type 2 diabetes.•Weight reduction was not associated with a reduction in major cardiovascular events.
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.
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 follow-up 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.
Among individuals who lost weight 2.5−4.9% and 5% or more during the first year, the hazard ratio for the incidence of drug-treated diabetes was 0.63 (95% CI 0.49−0.81, p = 0.0001), and 0.71 (95% CI 0.56−0.90, 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 one-year weight changes.
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.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33771515</pmid><doi>10.1016/j.pcd.2021.03.002</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3767-4223</orcidid><orcidid>https://orcid.org/0000-0003-4678-5555</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Primary care diabetes, 2021-06, Vol.15 (3), p.444-450 |
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| subjects | Cardiovascular events Follow-up Mortality Prevention Primary care Type 2 diabetes |
| title | Long-term outcomes of lifestyle intervention to prevent type 2 diabetes in people at high risk in primary health care |
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