Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS)
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Aims/hypothesis This study aimed to determine whether lifestyle intervention lasting for 4 years affected diabetes incidence, body weight, glycaemia or lifestyle over 13 years among individuals at high risk of type 2 diabetes.Methods Overweight, middle-aged men (n = 172) and women (n = 350) with impaired glucose tolerance were randomised in 1993-1998 to an intensive lifestyle intervention group (n = 265), aiming at weight reduction, dietary modification and increased physical activity, or to a control group (n = 257) that received general lifestyle information. The primary outcome was a diagnosis of diabetes based on annual OGTTs. Secondary outcomes included changes in body weight, glycaemia, physical activity and diet. After active intervention (median 4 years, range 1-6 years), participants still free of diabetes and willing to continue their participation (200 in the intervention group and 166 in the control group) were further followed until diabetes diagnosis, dropout or the end of 2009, with a median total follow-up of 9 years and a time span of 13 years from baseline.Results During the total follow-up the adjusted HR for diabetes (intervention group vs control group) was 0.614 (95% CI 0.478, 0.789; p < 0.001). The corresponding HR during the post-intervention follow-up was 0.672 (95% CI 0.477, 0.947; p = 0.023). The former intervention group participants sustained lower absolute levels of body weight, fasting and 2 h plasma glucose and a healthier diet. Adherence to lifestyle changes during the intervention period predicted greater risk reduction during the total follow-up.Conclusions/interpretation Lifestyle intervention in people at high risk of type 2 diabetes induces sustaining lifestyle change and results in long-term prevention of progression to type 2 diabetes.
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The Finnish Diabetes Prevention Study reported a decreased 3-year risk of diabetes by 58% in participants with prediabetes randomized to a lifestyle intervention promoting increased MVPA and healthy dietary changes.
“Similarly, the Finnish Diabetes Prevention Study (FDPS) also reported a decreased 3-year risk of diabetes by 58% in participants with prediabetes who were randomized to a lifestyle intervention promoting increased MVPA (≥150 min per week) and healthy dietary changes [ 91 , 94 ].”
From Physical activity, cardiorespiratory fitness, and cardiovascular health: A clinical practice statement of the American Society for Preventive Cardiology Part II: Physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations (2022) · cites this paper as [91]
The Introduction reports that the Finnish Diabetes Prevention Study achieved an almost 60% relative risk reduction, and Participants and interventions describes randomized participants with impaired glucose tolerance receiving dietary and physical-activity counselling. However, this paper does not give a 58% reduction specifically over three years; its reference to three years concerns follow-up after the intervention. It specifies an activity goal of at least four hours per week, not at least 150 minutes of MVPA. (LLM, conf=0.88)
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- Authors
- (DPS), F. T. F. D. P. S., Lindström, J., Peltonen, M., Eriksson, J. G., Ilanne-Parikka, P., Aunola, S., Keinänen-Kiukaanniemi, S., Uusitupa, M., & Tuomilehto, J.
- Affiliations
- Finnish Institute for Health and Welfare (FI)
- University of Helsinki (FI)
- Universität für Weiterbildung Krems (AT)
- Corresponding author
- Lindström, J.
- Venue
- Diabetologia
- Published
- 2012-10-24
- Volume
- 56
- Issue
- 2
- Pages
- 284-293
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W1997683054
- Cited by
- 551
- References
- 22
- Citations by year
- 2026: 22 · 2025: 38 · 2024: 34 · 2023: 40 · 2022: 33 · 2021: 46 · 2020: 36 · 2019: 33 · 2018: 45 · 2017: 48 · 2016: 51 · 2015: 50 · 2014: 49 · 2013: 23
- FWCI
- 31.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Foundation for Cardiovascular Research
- Yrjö Jahnssonin Säätiö
- Academy of Finland (129330, 128315)
- Juho Vainion Säätiö (129330, 128315)
- Novo Nordisk
- Sydäntutkimussäätiö
- Diabetestutkimussäätiö
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes prevention, lifestyle intervention, impaired glucose tolerance, long-term follow-up, weight loss, glycemia, physical activity, dietary change, diabetes incidence, overweight adults, Finnish Diabetes Prevention Study, post-intervention follow-up
- MeSH terms
- Adult, Blood Glucose, Body Weight, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Male, Middle Aged, Exercise
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