Cited by 10,873Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Treatment and ManagementObesity, Physical Activity, Diet

The DOI matches its Crossref record; 19 of the 19 references it cites were found in a registry or an index; 2 of the 5 sources its claims cite were checked for support.

Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance

Open access

Abstract

BACKGROUND: Type 2 diabetes mellitus is increasingly common, primarily because of increases in the prevalence of a sedentary lifestyle and obesity. Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known. METHODS: We randomly assigned 522 middle-aged, overweight subjects (172 men and 350 women; mean age, 55 years; mean body-mass index [weight in kilograms divided by the square of the height in meters], 31) with impaired glucose tolerance to either the intervention group or the control group. Each subject in the intervention group received individualized counseling aimed at reducing weight, total intake of fat, and intake of saturated fat and increasing intake of fiber and physical activity. An oral glucose-tolerance test was performed annually; the diagnosis of diabetes was confirmed by a second test. The mean duration of follow-up was 3.2 years. RESULTS: The mean (+/-SD) amount of weight lost between base line and the end of year 1 was 4.2+/-5.1 kg in the intervention group and 0.8+/-3.7 kg in the control group; the net loss by the end of year 2 was 3.5+/-5.5 kg in the intervention group and 0.8+/-4.4 kg in the control group (P<0.001 for both comparisons between the groups). The cumulative incidence of diabetes after four years was 11 percent (95 percent confidence interval, 6 to 15 percent) in the intervention group and 23 percent (95 percent confidence interval, 17 to 29 percent) in the control group. During the trial, the risk of diabetes was reduced by 58 percent (P<0.001) in the intervention group. The reduction in the incidence of diabetes was directly associated with changes in lifestyle. CONCLUSIONS: Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects.

Overview

Integrity signals

Registry

Crossref · 10.1056/nejm200105033441801

Cites

19 of 19 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

24 Own result · 14 Own method · 5 Own interpretation · 2 Sources not found · 1 Supported · 1 Supported so far

Show all 18 claims

  • It may state two separate claims as one. 21
  • Probably not a substantial claim. 14
  • The quote only partly states this claim. 1
29 of 29
  • The paper relies on this without support.

    The success score computed from grades for intervention goals validly reflects the extent of lifestyle changes achieved.

    “subjects were given a grade for each goal of the intervention at the one-year visit (with 0 indicating that it was not achieved or 1 indicating that it was achieved), and a success score was computed as the sum of these grades.”
    “At the one-year visit, each subject received a grade of 0 for each intervention goal that had not been achieved and a grade of 1 for each goal that had been achieved; the success score was computed as the sum of the grades.”
  • The paper relies on this without support.

    Withdrawal from the study and censoring at the last oral glucose-tolerance test do not bias the estimated intervention effect.

    “Subjects who withdrew from the study were considered to be at risk for diabetes until their last oral glucosetolerance test, at which point data were censored.”
  • The paper relies on this without support.

    The study subjects with impaired glucose tolerance are representative of the high-risk subjects to whom the prevention conclusion generalizes.

    “middle-aged, overweight subjects (172 men and 350 women; mean age, 55 years; mean body-mass index [weight in kilograms divided by the square of the height in meters], 31) with impaired glucose tolerance”
    “high-risk subjects”
  • The paper relies on this without support.

    Self-reported dietary and exercise habits accurately reflect actual lifestyle changes.

    “The study subjects were asked about their healthrelated behavior at base line and subsequently at each annual follow-up examination (Table 3).”
    “They completed a three-day food diary at base line and at each annual visit, using a booklet illustrating the sizes of portions of food.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

1 of 1

Citations

Cites

Show all 19 references

Research works printed but not linked: 4

  1. Neel JV, 1962, Am J Hum Genet, 14, 353
  2. Tuomilehto J, Tuomilehto-Wolf E, Zimmet P, Alberti K, Knowler W. Primary prevention of diabetes mellitus. In: Alberti K, Zimmet P, DeFronzo R, Keen H, eds. International textbook of diabetes mellitus. Chichester, England: John Wiley, 1997:1799-827.
  3. 1994, WHO Tech Rep Ser, 844, 1
  4. 1985, WHO Tech Rep Ser, 727, 7

Cited by

Sorted by citations

Items 2,601–2,700 of 10,870

Metadata

Authors
Tuomilehto, J., Lindström, J., Eriksson, J. G., Valle, T. T., Hämäläinen, H., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Laakso, M., Louheranta, A., Rastas, M., Salminen, V., Aunola, S., Cepaitis, Z., Moltchanov, V., Hakumäki, M., Mannelin, M., Martikkala, V., Sundvall, J., & Uusitupa, M.
Affiliations
  • University of Helsinki (FI)
  • University of Oulu (FI)
  • Social Insurance Institution (FI)
  • Oulu University Hospital (FI)
  • University of Eastern Finland (FI)
  • Oulu Deaconess Institute (FI)
Venue
New England Journal of Medicine
Published
2001-05-03
Volume
344
Issue
18
Pages
1343-1350
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2332951586
Cited by
10,873
References
19
Citations by year
2026: 152 · 2025: 198 · 2024: 256 · 2023: 223 · 2022: 289 · 2021: 341 · 2020: 346 · 2019: 336 · 2018: 430 · 2017: 402 · 2016: 441 · 2015: 476 · 2014: 549 · 2013: 566 · 2012: 553
FWCI
320.22
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
type 2 diabetes prevention, impaired glucose tolerance, lifestyle intervention, weight loss, nutrition counseling, saturated fat intake, dietary fiber, physical activity, overweight adults, diabetes incidence
MeSH terms
Diabetes Mellitus, Type 2, Dietary Fiber, Female, Glucose Tolerance Test, Humans, Life Style, Male, Middle Aged, Obesity, Risk, Weight Loss, Exercise, Incidence, Glucose Intolerance, Diet, Fat-Restricted

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-11, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-11 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review