Lifestyle Intervention for Prevention of Type 2 Diabetes in Primary Health Care

One-year follow-up of the Finnish National Diabetes Prevention Program (FIN-D2D)

  1. Sirkka Keinänen-Kiukaanniemi, MD7,11
  1. 1Pirkanmaa Hospital District, Tampere, Finland;
  2. 2Finnish Diabetes Association, Tampere, Finland;
  3. 3Department of Medicine, Kuopio University Hospital, Northern Savo Hospital District, Kuopio, Finland;
  4. 4Department on Internal Medicine, South Ostrobothnia Hospital District, Seinäjoki, Finland;
  5. 5Unit of Family Practice, Central Finland Hospital District, Jyväskylä, and Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland;
  6. 6Department of Internal Medicine, Central Finland Hospital District, Jyväskylä, Finland;
  7. 7University of Oulu, Institute of Health Sciences, Faculty of Medicine, Oulu, Finland;
  8. 8National Institute for Health and Welfare, Helsinki, Finland;
  9. 9Department of Public Health, University of Helsinki, Helsinki, Finland;
  10. 10Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;
  11. 11North Ostrobothnia Hospital District, Oulu, Finland.
  1. Corresponding author: Leena Moilanen, leena.moilanen{at}


OBJECTIVE To investigate 1-year outcomes of a national diabetes prevention program in Finland.

RESEARCH DESIGN AND METHODS Altogether 10,149 individuals at high risk for diabetes were identified with the Finnish Diabetes Risk Score (FINDRISC; scoring ≥15 points), by a history of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), cardiovascular disease, or gestational diabetes mellitus in 400 primary health care centers. One-year follow-up data were available for 2,798 participants who were nondiabetic at baseline (919 men and 1,879 women, aged 56.0 ± 9.9 and 54.0 ± 10.7 years [mean ± SD] with BMI 30.9 ± 4.6 and 31.6 ± 5.4 kg/m2).

RESULTS The incidence of diabetes was 2.0 and 1.2% in men and women with normal glucose tolerance at baseline, 13.5 and 7.4% in those with IFG, and 16.1 and 11.3% in those with IGT, respectively. Altogether 17.5% of the subjects lost ≥5% weight with no sex difference. The relative risk of diabetes was 0.31 (95% CI 0.16–0.59) in the group who lost ≥5% weight, 0.72 (0.46–1.13) in the group who lost 2.5–4.9% weight, and 1.10 (0.77–1.58) in the group who gained ≥2.5% compared with the group who maintained weight.

CONCLUSIONS The FIN-D2D was the first national effort to implement the prevention of diabetes in a primary health care setting. Methods for recruiting high-risk subjects were simple and easy to use. Moderate weight loss in this very high-risk group was especially effective in reducing risk of diabetes among those participating in the program.


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  • Received March 2, 2010.
  • Accepted July 13, 2010.

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  1. Diabetes Care vol. 33 no. 10 2146-2151
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