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)

Original Research

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

¹Pirkanmaa Hospital District, Tampere, Finland;
²Finnish Diabetes Association, Tampere, Finland;
³Department of Medicine, Kuopio University Hospital, Northern Savo Hospital District, Kuopio, Finland;
⁴Department on Internal Medicine, South Ostrobothnia Hospital District, Seinäjoki, Finland;
⁵Unit of Family Practice, Central Finland Hospital District, Jyväskylä, and Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland;
⁶Department of Internal Medicine, Central Finland Hospital District, Jyväskylä, Finland;
⁷University of Oulu, Institute of Health Sciences, Faculty of Medicine, Oulu, Finland;
⁸National Institute for Health and Welfare, Helsinki, Finland;
⁹Department of Public Health, University of Helsinki, Helsinki, Finland;
¹⁰Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland;
¹¹North Ostrobothnia Hospital District, Oulu, Finland.

Diabetes Care 2010 Oct; 33(10): 2146-2151. https://doi.org/10.2337/dc10-0410

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Figure 1
Incidence of type 2 diabetes during the 1-year follow-up according to weight loss. Data are adjusted to age 50 years. P < 0.001 for the likelihood ratio test for the difference of probabilities according to weight loss.

Table 1

Baseline characteristics and changes in risk factors from baseline to 1-year visit in men and women

	n	Baseline	Change from baseline to one-year follow-up	P value^*
Men
Age (years)	919	56.0 ± 9.9)
FINDRISC score	536	16.6 ± 3.7
Weight (kg)	919	95.8 ± 15.9	−1.2 ± 5.3	<0.0001
BMI (kg/m²)^*	914	30.9 ± 4.6	−0.4 ± 1.5	<0.0001
Waist (cm)	888	107.3 ± 11.4	−1.3 ± 4.9	<0.0001
Systolic blood pressure (mmHg)	903	141.0 ± 16.2	−0.8 ± 14.8	0.0932
Diastolic blood pressure (mmHg)	903	87.2 ± 9.6	−1.5 ± 8.9	<0.0001
Total cholesterol (mmol/l)	822	5.06 ± 1.01	−0.25 ± 0.86	<0.0001
HDL cholesterol (mmol/l)	814	1.25 ± 0.33	0.02 ± 0.22	0.0030
LDL cholesterol (mmol/l)	779	3.03 ± 0.87	−0.23 ± 0.76	<0.0001
Triglycerides (mmol/l)	811	1.80 ± 1.19	−0.11 ± 1.12	0.0050
Women
Age (years)	1,879	54.0 ± 10.7
FINDRISC Score	1,259	17.2 ± 3.0
Weight (kg)	1,879	83.8 ± 15.4	−1.1 ± 5.8	<0.0001
BMI (kg/m²)	1,872	31.6 ± 5.4	−0.4 ± 2.1	<0.0001
Waist (cm)	1,821	99.4 ± 12.4	−1.3 ± 5.9	<0.0001
Systolic blood pressure (mmHg)	1,845	138.4 ± 17.8	−1.9 ± 14.8	<0.0001
Diastolic blood pressure (mmHg)	1,845	85.3 ± 9.2	−1.6 ± 8.4	<0.0001
Total cholesterol (mmol/l)	1,658	5.24 ± 0.95	−0.14 ± 0.79	<0.0001
HDL cholesterol (mmol/l)	1,639	1.50 ± 0.43	0.04 ± 0.31	<0.0001
LDL cholesterol (mmol/l)	1,616	3.07 ± 0.86	−0.16 ± 0.76	<0.0001
Triglycerides (mmol/l)	1,632	1.48 ± 0.77	−0.03 ± 0.64	0.0769

Data are means ± SD.
↵*P value for ANCOVA comparing the mean at follow-up to the mean at baseline; analyses were adjusted for age.

Table 2

Changes in risk factors from baseline to 1-year visit according to weight loss

	Weight loss ≥5%		Weight loss 2.5–4.9%		Stable weight^*		Gained ≥2.5%		ANCOVA P value^†
	n	Mean ± SD	n	Mean ± SD	n	Mean ± SD	n	Mean ± SD	ANCOVA P value^†
Weight (kg)	490	−8.5 ± 6.5^‡^§	471	−3.1 ± 0.9^‡^§	1,290	−0.1 ± 1.2	546	4.5 ± 3.7^‡^§	<0.001
BMI (kg/m²)	489	−3.0 ± 2.3^‡^§	470	−1.1 ± 0.3^‡^§	1,285	−0.04 ± 0.46	541	1.6 ± 1.0^‡^§	<0.001
Waist (cm)	477	−6.6 ± 6.1^‡^§	449	−2.7 ± 4.2^‡^§	1,258	−0.4 ± 4.2	525	2.6 ± 5.1^‡^§	<0.001
Systolic blood pressure (mmHg)	480	−4.4 ± 14.4^‡^§	464	−3.1 ± 15.4^‡^§	1,267	−0.7 ± 14.5	536	0.5 ± 15.1^‡	<0.001
Diastolic blood pressure (mmHg)	480	−3.8 ± 8.4^‡^§	464	−2.2 ± 8.3	1,267	−1.1 ± 8.4	536	−0.1 ± 8.7	<0.001
Lipids (mmol/l)
Total cholesterol	438	−0.35 ± 0.78	411	−0.23 ± 0.92	1,148	−0.15 ± 0.78	482	−0.02 ± 0.81^‡^§	<0.001
HDL cholesterol	430	0.10 ± 0.25^‡^§	408	0.05 ± 0.29	1,138	0.02 ± 0.27	476	−0.01 ± 0.31	<0.001
LDL cholesterol	420	−0.33 ± 0.71^‡^§	400	−0.22 ± 0.89	1,111	−0.17 ± 0.72	463	−0.07 ± 0.74^‡	<0.001
Triglycerides	430	−0.29 ± 0.66^‡^§	406	−0.15 ± 0.95^‡^§	1,133	−0.01 ± 0.76	473	0.12 ± 0.95^‡^§	<0.001

↵*Weight loss <2.5% or weight gain <2.5%.
↵†ANCOVA for overall and pairwise comparisons of mean changes between the groups; analyses were adjusted for age (‡) or for age and sex (§).
↵‡Pairwise comparisons between groups, P < 0.05 (stable weight served as the reference group).
↵§Pairwise comparisons between groups, P < 0.05 (stable weight served as the reference group).