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 accessAbstract
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.
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24 Own result · 14 Own method · 5 Own interpretation · 2 Sources not found · 1 Supported · 1 Supported so far
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · plain
“At four years, the cumulative incidence 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.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Abstract
plain- Asserted: passes — The authors put it forward as true.
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- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During the trial, the risk of diabetes was reduced by 58 percent (P<0.001) in the intervention group.”
- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · plain
“the cumulative incidence of diabetes was 58 percent lower in the intervention group than in the control group (hazard ratio, 0.4; 95 percent confidence interval, 0.3 to 0.7; P<0.001).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Abstract
plainstates a cause- Asserted: passes — The authors put it forward as true.
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- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reduction in the incidence of diabetes was directly associated with changes in lifestyle.”
- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · boosted
“There was a strong inverse correlation between the success score and the incidence of diabetes.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Abstract
boostedstates an association- Asserted: passes — The authors put it forward as true.
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- Rests on an assumption: The success score computed from grades for intervention goals validly reflects the extent of lifestyle changes achieved.
- Also stated in: § T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C · boosted
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetes had not developed in any of the subjects who reached four or five of the goals (49 subjects in the intervention group and 15 in the control group).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
plainn = 49- Asserted: passes — The authors put it forward as true.
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In the paper
“According to a univariate analysis, the odds ratio for diabetes in subjects in the intervention group who had lost more than 5 percent of their initial weight by the one-year follow-up visit was 0.3 (95 percent confidence interval, 0.1 to 0.7) as compared with those in the intervention group who had lost less weight or none at all;”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the subjects in the intervention group who did not reach the goal of losing 5 percent of their initial weight, the odds ratio for diabetes in those who had achieved the goal with respect to exercise (more than four hours per week) during the first year was 0.2 (95 percent confidence interval, 0.1 to 0.6) as compared with those in the intervention group who maintained a sedentary lifestyle;”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
plainstates an association- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“on the other hand, the failure to make any changes resulted in an incidence of diabetes that was close to the estimate of 35 percent for this high-risk population.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
plainstates a cause- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The proportion of subjects in the intervention group who succeeded in achieving a particular goal varied from 25 percent (fiber intake) to 86 percent (exercise).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the corresponding odds ratio in the control group was 0.4 (95 percent confidence interval, 0.1 to 1.2).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
plain- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Achieving a relatively conservative target of more than four hours of exercise per week was associated with a significant reduction in the risk of diabetes in the subjects who did not lose weight.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
plainstates an association- Asserted: passes — The authors put it forward as true.
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- It may state two separate claims as one. 21
- Probably not a substantial claim. 14
- The quote only partly states this claim. 1
Every source the paper cites for this claim was checked and supports it.
In the paper
“The changes in lifestyle in our study not only improved glucose tolerance but also reduced the magnitude of several other cardiovascular risk factors.13”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
What the sources say
- Supportedcites [13] source
The Results report lower fasting and 2-hour plasma glucose after one year in the lifestyle-intervention group. They also report improved anthropometric measures, lower triglycerides, and greater reductions in blood pressure than in the control group. (LLM, conf=0.93)
plainstates a cause- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“The results from previous studies in Sweden 17 and China 18 also provide evidence that changes in lifestyle are effective in preventing diabetes, and the magnitude of the benefit in these studies was similar to that in our study.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
What the sources say
- Supportedcites [17] source
The paper’s ‘Prevalence of Type 2 diabetes and IGT at follow-up’ section reports diabetes in 10.6% of the Swedish lifestyle-intervention group versus 28.6% of the untreated IGT reference group, supporting the cited point that lifestyle changes may prevent or postpone diabetes. The comparison with ‘our study’ is the citing authors’ own assessment, not a finding attributed to this source. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [18] source
plainstates a cause- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the net loss by the end of year 2 was 3.5±5.5 kg in the intervention group and 0.8±4.4kg in the control group (P<0.001 for both comparisons between the groups).”
- Also stated in: § RESULTS · plain
“At two years, the decrease in weight remained significantly greater in the intervention group (3.5±5.5 kg) than in the control group (0.8±4.4 kg) (P<0.001).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Abstract
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean (±SD) amount of weight lost be- tween 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”
- Also stated in: § RESULTS · plain
“During the first year, the mean (±SD) body weight decreased by 4.2±5.1 kg (4.7±5.4 percent) in the intervention group and by 0.8±3.7 kg (0.9±4.2 percent) in the control group (P<0.001)”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Abstract
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The incidence of diabetes was 63 percent lower among men in the intervention group (95 percent confidence interval, 18 to 79 percent; P=0.01) and 54 percent lower among women (95 percent confidence interval, 26 to 81 percent; P=0.008).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C
plainstates a cause- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Waist circumference, the fasting plasma glucose concentration, the plasma glucose concentration two hours after oral glucose challenge, and the serum insulin concentration two hours after glucose challenge decreased significantly more among subjects in the intervention group than among those in the control group.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainstates a cause- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The average proportion of subjects in whom impaired glucose tolerance progressed to diabetes was 3 percent per year in the intervention group and 6 percent per year in the control group.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainn = 86- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Diabetes was diagnosed in a total of 86 subjects -27 in the intervention group and 59 in the control group.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainn = 86- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At this time, the mean change from base line in the fasting plasma glucose concentration was -2±12 mg per deciliter (-0.1±0.7 mmol per liter) in the intervention group and +3±14 mg per deciliter (+0.2±0.8 mmol per liter) in the control group (P<0.001);”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“According to our results, 22 subjects with impaired glucose tolerance must be treated in this way for one year -or 5 subjects for five years -to prevent one case of diabetes.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
plainstates a cause- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the corresponding odds ratio in the control group was 0.6 (95 percent confidence interval, 0.3 to 1.1).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
plainstates an association- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The subjects in the intervention group were more likely to report changes in dietary and exercise habits.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainstates an association- Asserted: passes — The authors put it forward as true.
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The quote only partly states this claim.
- Rests on an assumption: Self-reported dietary and exercise habits accurately reflect actual lifestyle changes.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The absolute incidence of diabetes was 32 cases per 1000 person-years in the intervention group and 78 per 1000 personyears in the control group.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainn = 86- Asserted: passes — The authors put it forward as true.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were also significantly greater decreases in the intervention group than in the control group in the serum insulin concentration two hours after oral glucose challenge, as well as in the triglyceride concentration and blood pressure (data not shown).”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > RESULTS
plainstates a cause- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We required confirmation of the diagnosis of diabetes by a second oral glucose-tolerance test; if the diagnosis was not confirmed by the second test, the subject followed the program according to the original random assignment.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Assessment of the End Points
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The end-points committee excluded one subject who had diabetes at base line whose diagnosis of diabetes was confirmed at her two-year visit.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Study Design
plainSingle case- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study protocol was approved by the ethics committee of the National Public Health Institute in Helsinki, Finland, and all the study subjects gave written informed consent.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Study Design
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All analyses of end points were based on the intention-to-treat principle.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reasonably low dropout rate in our study also indicates that subjects with impaired glucose tolerance are willing and able to participate in a demanding intervention program if it is made available to them.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
hedgedstates a possible cause- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“In March 2000, an independent statistician completed the first analysis of data, which included all cases of diabetes diagnosed before that date.On the basis of the results of this analysis, the endpoints committee recommended that the trial be ended.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The independent end-points committee confirmed all newly diagnosed cases of diabetes.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Assessment of the End Points
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Rests on an assumption: Withdrawal from the study and censoring at the last oral glucose-tolerance test do not bias the estimated intervention effect.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Laboratory staff did not know the subjects' group assignments, and the subjects were not informed of their plasma glucose concentrations during follow-up unless diabetes was diagnosed.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Study Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study centers did not exchange information concerning the number of subjects who reached the end point, and the end-point data were linked to the group assignment at the study center only after a total of 80 subjects had reached the end point, as stated in the study plan.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Assessment of the End Points
plainn = 80- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The glucose measurements were standardized by the central laboratory in Helsinki, whose staff analyzed 60 to 80 plasma samples from each center in duplicate.A linear-regression equation was calculated for each center, with the use of the plasma glucose measurement determined at the Helsinki laboratory as the standard.These equations were used to correct the locally measured plasma glucose values.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Biochemical Assessments
plainn = 80- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Subjects who enrolled in the study were randomly assigned to the intervention group or the control group by the study physician, with the use of a randomization list, with stratification according to center, sex, and the mean plasma glucose concentration two hours after oral glucose challenge (140 to 169 mg per deciliter or 170 to 200 mg per deciliter [7.8 to 9.4 mmol per liter or 9.5 to 11.0 mmol”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Study Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the staff members involved in the intervention had to be aware of the group assignment; thus, the study was only partly blinded.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Study Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“During the study, 40 subjects (8 percent) withdrew -23 in the intervention group and 17 in the control group.”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > Cumulative Probability of Remaining Free of Diabetes
plainn = 40- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Many also have hypertension and an atherogenic serum lipid profile.[19][20][21][22]”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > DISCUSSION
What the sources say
- Not matchedcites [19][20][21][22]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
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.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although lifestyle interventions393 and weight loss394 reverse T2DM in early stages, when insulin is still secreted, T2DM patients may become dependent on anti-diabetic drugs in later stages.”
From Pancreatic regulation of glucose homeostasis. (2016) · cites this paper as [393]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In four of these studies ( 2 – 5 ), diabetes rates decreased in relation to substantial reductions in body weight, whereas in the Indian trial ( 6 ) lifestyle intervention was successful despite no weight loss.”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Lifestyle modification in both studies reduced incident diabetes by 58% and, in the DPP, had a greater effect than metformin (31%).”
From Exercise and Type 2 Diabetes (2010) · cites this paper as [260]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The most robust research available related to eating patterns for prediabetes or type 2 diabetes prevention are Mediterranean-style, low-fat, or lowcarbohydrate eating plans (26,69,74,75).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [74]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In addition, physical training can play a significant role in the prevention of insulin resistance and type 2 diabetes [22–25].”
From Patients with type 2 diabetes have normal mitochondrial function in skeletal muscle (2007) · cites this paper as [25]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Randomized controlled trials have shown that individuals at high risk for developing diabetes (those with IFG, IGT, or both) can be given interventions that significantly decrease the rate of onset of diabetes (10–16).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [11]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Interventions that focussed on physical activity during early pregnancy have been shown to reduce the development of GDM [23, 27] and type 2 diabetes in at risk individuals [16, 56].”
From Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus—a systematic review and meta-analysis of 257,876 pregnancies (2023) · cites this paper as [16]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Diet-induced fat loss is recommended for obese patients who have these cardiometabolic risk factors, because even moderate (e.g., 10%) weight loss improves all risk factors simultaneously (1-3).”
From Long-term Effects of Large-volume Liposuction on Metabolic Risk Factors for Coronary Heart Disease (2008) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Small long-term reductions in body weight (fat) improve glucose tolerance and the other metabolic CHD risk factors evaluated in the present study (2,3,12-14).”
From Long-term Effects of Large-volume Liposuction on Metabolic Risk Factors for Coronary Heart Disease (2008) · cites this paper as [3]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The composite outcome, as defined by the CDC in its 2021 standards,29 comprises elements that have each been associated with reduced risk of progression to diabetes.30-34”
From An AI-Powered Lifestyle Intervention vs Human Coaching in the Diabetes Prevention Program: A Randomized Clinical Trial (2025) · cites this paper as [30]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Regular physical activity, which can contribute to both weight loss and prevention of weight regain, and behavioral strategies are also important components of lifestyle therapy for weight management (26,74,83,135 -137).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [74]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Moreover, the ef fi cacy of interventions for primary prevention of type 2 diabetes has mainly been demonstrated among individuals who have impaired glucose tolerance (IGT) with or without elevated fasting glucose, not for individuals with isolated impaired fasting glucose (IFG) or for those with prediabetes de fi ned by A1C criteria (5 -8).”
From 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024 (2024) · cites this paper as [6]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The DPP and other clinical trials12–16 have established the feasibility of interruption of the worsening of hyperglycaemia in overweight people who have raised fasting or postload glycaemia.”
From 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study (2009) · cites this paper as [13]
The cited source says what the claim attributes to it.
In the citing paper
“Similar to the DPP trial, the FDPS also demonstrated a 70% reduction in diabetes incidence after adjustment for baseline confounders in individuals who met their PA activity goal (>4 hr-week) but did not meet the accompanying weight loss goal (>5% weight loss) [95] .”
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 [95]
The cited source says what the claim attributes to it.
In the citing paper
“Five clinical trials that examined the effects of reputedly healthy, energy-restricted diets together with increased physical activity in individuals with impaired glucose tolerance, a prediabetic stage, showed risk reductions between 30 and 70% ( 2 – 6 ).”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“The results of these studies provide convincing evidence that lifestyle modification reduces the incidence of diabetes among high-risk individuals.”
From Reduction in the Incidence of Type 2 Diabetes With the Mediterranean Diet (2011) · cites this paper as [3]
The cited source says what the claim attributes to it.
In the citing paper
“Regular physical activity by itself (155,156) or as part of a comprehensive lifestyle plan (26,74,83,151) can prevent progression to type 2 diabetes in highrisk individuals.”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [74]
The cited source says what the claim attributes to it.
In the citing paper
“In both the Finnish Diabetes Prevention Study (60) and the U.S. Diabetes Prevention Program (DPP) (61), lifestyle intervention significantly reduced diabetes incidence by 58%.”
From Globalization of Diabetes (2011) · cites this paper as [60]
The cited source says what the claim attributes to it.
In the citing paper
“These interventions include intensive lifestyle modification programs that have been shown to be very effective (≥58% reduction after 3 years) and use of the pharmacologic agents metformin, acarbose, orlistat, and thiazolidinediones (TZDs), each of which has been shown to decrease incident diabetes to various degrees.”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [11]
The cited source says what the claim attributes to it.
In the citing paper
“Lifestyle interventions are proven to effectively prevent type-2 diabetes [16].”
From Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus—a systematic review and meta-analysis of 257,876 pregnancies (2023) · cites this paper as [16]
The cited source says what the claim attributes to it.
In the citing paper
“Although interventions can clearly reduce diabetes incidence over a period of a few years,1–5 it is not well known how long their effects persist, especially when interventions cease or become less intensive.”
The cited source says what the claim attributes to it.
In the citing paper
“Several large type 2 diabetes prevention RCTs (26,74,83,84) used low-fat eating plans to achieve weight loss and improve glucose tolerance, and some demonstrated decreased incidence of diabetes (26,74,83).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [74]
The cited source says what the claim attributes to it.
In the citing paper
“Intensive lifestyle intervention has also been shown to prevent or delay the development of type 2 diabetes in other studies.15, 26”
From Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes (2013) · cites this paper as [26]
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Combination therapy with insulin and oral glucose‐lowering agents (SUs 13 , 14 , fast‐acting insulin secretagogues [glinides] 15 , 16 , 17 ), biguanides 18 , 19 , 20 , 21 , α‐glucosidase inhibitors 22 , 23 , insulin sensitizers 24 , 25 , 26 , 27 , and, DPP‐4 inhibitors 28 , and SGLT2 inhibitors 29 or GLP‐1 receptor agonists 30 are shown to improve glycemic control and reduce the insulin dose being”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
Experimental — accuracy not yet measuredIn the citing paper
“In the Diabetes Prevention Program (DPP) and the Finnish trials, lifestyle intervention including modest weight loss was effective in preventing the development of diabetes in a high risk population [15,16].”
From The case for low carbohydrate diets in diabetes management (2005) · cites this paper as [16]
In the citing paper
“All three of these large intervention studies showed a reduction in risk to develop Type 2 diabetes by up to 58% compared to placebo.”
From The relative contributions of insulin resistance and beta-cell dysfunction to the pathophysiology of type 2 diabetes (2003) · cites this paper as [159]
In the citing paper
“Despite these recommendations and the demonstration that interventions can delay and sometimes prevent the onset of type 2 diabetes in individuals with impaired glucose tolerance (26,27), there is as yet no published evidence that treatment based on screening has an effect on long-term complications.”
From Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus (2011) · cites this paper as [27]
In the citing paper
“Clearly lifestyle interventions, including exercise training and at least mild weight reduction with caloric restriction, showed a nearly 60% reduction in the risk of developing DM, which was considerably better than that noted in patients treated with metformin (73,74).”
From Obesity and Cardiovascular Disease (2009) · cites this paper as [74]
In the citing paper
“Clearly lifestyle interventions, including exercise training and at least mild weight reduction with caloric restriction, showed a nearly 60% reduction in the risk of developing DM, which was considerably better than that noted in patients treated with metformin (73,74).”
From Obesity and Cardiovascular Disease (2009) · cites this paper as [74]
In the citing paper
“Both microalbuminuria and retinopathy increase with diabetes duration and severity is related to glycaemic control163,164.”
From Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future (2014) · cites this paper as [164]
In the citing paper
“Several trials have demonstrated reductions in the risk of developing diabetes among prediabetic individuals after lifestyle and drug-based interventions.15,24–28”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [28]
In the citing paper
“In the first trial, the benefits were dependent on the number of goals achieved by the participant (weight reduction >5%, fat intake< 30%, saturated fat intake < 10%, fiber intake >15g/1000 kcal, exercise > 4h/week),28 while in the DPP the most important determinant of risk reduction was weight loss (each 1-kg decrease reduced the risk by 16%).90”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [28]
In the citing paper
“The Finnish Diabetes Prevention Study and, the largest to date, the US DPP with a 3-year follow-up found a 58% risk reduction after interventions aimed at weight loss, dietary change and increase in physical activity.25,28”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [28]
In the citing paper
“The accretion of lean tissue with exercise has a potentially beneficial effect in preventing diabetes and metabolic syndrome [330], functional dependency, falls, and fractures as well as in the treatment of chronic diseases and disabilities that are often accompanied by disuse, catabolism, and sarcopenia.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [330]
In the citing paper
“The accretion of lean tissue with exercise has a potentially beneficial effect in preventing diabetes and metabolic syndrome [330], functional dependency, falls, and fractures as well as in the treatment of chronic diseases and disabilities that are often accompanied by disuse, catabolism, and sarcopenia.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [330]
In the citing paper
“There is good evidence that complex interventions, including dietary changes, can prevent the progression of impaired glucose tolerance to diabetes (1,2).”
From Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes (2013) · cites this paper as [1]
In the citing paper
“Given the availability of effective interventions for delaying or preventing the onset of type 2 diabetes and the increasing burden of the condition worldwide, earlier identification of individuals at risk is particularly important3-6.”
From Metabolite profiles and the risk of developing diabetes (2011) · cites this paper as [4]
In the citing paper
“In metabolic syndrome patients with IFG (or IGT if assessed), weight reduction, increased physical activity, or both will delay (or prevent) the onset of type 2 diabetes mellitus.145,174”
From Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement (2005) · cites this paper as [174]
In the citing paper
“However, they should abstain from sucrose‐rich sweets and juices, which are thought likely to worsen glycemic control and promote the metabolic syndrome 15 , 16 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Despite lack of consensus on its role in improving glycemic control in patients with type 1 diabetes, long‐term exercise is shown to reduce risk factors for cardiovascular disease and improve quality of life (QOL) 15 , 16 , 17 , 18 (grade B: 100% agreement).”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“While the risk of hypoglycemia with DPP‐4 inhibitor monotherapy is small, combination therapy with an SU or insulin often increases the risk of hypoglycemia, suggesting the rationale for reducing the dose of either partnering agent 14 , 15 , 16 , 17 , 18 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“While the risk of hypoglycemia with DPP‐4 inhibitor monotherapy is small, combination therapy with an SU or insulin often increases the risk of hypoglycemia, suggesting the rationale for reducing the dose of either partnering agent 14 , 15 , 16 , 17 , 18 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“A number of reports in the literature suggest that real‐time continuous glucose monitoring (rt‐CGM) may be more effective than self‐monitoring of blood glucose (SMBG) in improving glycemic control not only in pediatric and adult patients with type 1 diabetes but in adult patients with type 2 diabetes 13 , 14 , 15 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Diabetic retinopathy is a risk factor for diabetic nephropathy and macroangiopathy 15 , 16 , 17 , 18 , 19 , 20 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Anti‐dyslipidemic agents (e.g., fibrates, statins) are shown likely to be effective in inhibiting the progression of diabetic nephropathy in patients with intact renal function 14 , 15 , 16 (grade B: 81% agreement).”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Foot ulcer treatment has been shown to be effective in maintaining the QOL of affected patients 14 , 15 (grade A: 100% agreement).”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Lipid control has been shown to be effective in the primary and secondary prevention of diabetic macroangiopathy 14 , 15 (grade A: 100% agreement).”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Given that mental/psychological factors have been shown to significantly affect the patient’s diabetes management and prognosis, mental/psychological counseling is to be offered with sufficient care given to addressing individual differences in mental/psychological maturity 14 , 15 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“Not only aerobic exercise but muscle training is associated with a reduced risk of type 2 diabetes, with their combination shown to markedly decrease the risk further 14 , 15 .”
From Japanese clinical practice guideline for diabetes 2019 (2020) · cites this paper as [15]
In the citing paper
“which may have important therapeutic implications for prevention and treatment of T2DM in this ethnic group and possibly explain the lower efficacy of lifestyle intervention in the Indian diabetes prevention study compared with the U.S. and Finnish diabetes prevention studies (33-35).”
From Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian-Indian men (2006) · cites this paper as [33]
In the citing paper
“Furthermore, randomized controlled clinical trials have shown that weight loss and increased physical activity reduce the incidence of type 2 diabetes in high-risk individuals, including American Indians, who have IGT (27,28).”
From Effects of Traditional and Western Environments on Prevalence of Type 2 Diabetes in Pima Indians in Mexico and the U.S. (2006) · cites this paper as [27]
In the citing paper
“However, randomized controlled trial evidence of dietary interventions and diabetes prevention only exists for low-fat, low-calorie, plus/minus high-fiber diets (22,32).”
From Diabetes and Cancer (2010) · cites this paper as [32]
In the citing paper
“In the Finnish Diabetes Prevention Program, weight loss counseling targeted to 5% total body weight, decreased total and saturated fat consumption, increased fiber consumption and increased activity to 30 min/day resulted in a 58% reduction in incident T2DM in individuals with IGT and BMI greater than 25 kg/m2.”
From The Vasculature in Prediabetes (2018) · cites this paper as [188]
In the citing paper
“In adults at risk for diabetes, a program of diet and physical activity reduced the risk of diabetes by 58%, with size of the decrease related to the extent of change in lifestyle.159”
From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of The Obesity Society and the American Society of Hypertension (2013) · cites this paper as [159]
In the citing paper
“The efficacy of interventions for primary prevention of type 2 diabetes (10–16) has primarily been demonstrated among individuals with IGT, not individuals with IFG (who do not also have IGT).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [11]
In the citing paper
“These interventions include intensive lifestyle modification programs that have been shown to be very effective (≥58% reduction after 3 years) and use of the pharmacologic agents metformin, acarbose, orlistat, and thiazolidinediones (TZDs), each of which has been shown to decrease incident diabetes to various degrees.”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [11]
In the citing paper
“Furthermore, regular exercise may prevent type 2 diabetes in high-risk individuals (10–12).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [11]
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 2. C HANGES IN S ELECTED C LINICAL AND M ETABOLIC V ARIABLES FROM B ASE -L INE TO THE E ND OF Y EAR 1 IN THE S UBJECTS IN THE I NTERVENTION AND C
“Change in serum insulin (mg/ml) Fasting 2 Hr after oral glucose challenge”
§ PREVENTION OF TYPE 2 DIABETES MELLITUS BY CHANGES IN LIFESTYLE AMONG SUBJECTS WITH IMPAIRED GLUCOSE TOLERANCE > T ABLE 1. B ASE -L INE C HARACTERISTICS OF THE S UBJECTS IN THE I NTERVENTION AND C
“Serum insulin ( m U/ml) Fasting 2 Hr after oral glucose challenge”
Citations
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“In addition to medications and diet interventions, exercise is considered one of the most traditionally used modalities for the treatment of type 2 diabetes [30, 31], and changes in lifestyle can reduce the incidence of T2DM to 58% in both genders at high cardiovascular risk [32].”
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“6–10 For example, the Diabetes Prevention Program, 6 7 the Finnish Diabetes Prevention Study 8 and the Da Qing study 9 reduced the risk of progression to T2D by up to 58% over 3 years, with the protective benefit persisting for up to 10 years.”
Kim, J., Kim, B., Kim, M. K., Baek, K., Song, K., Han, K., & Kwon, H. (2024) · Journal of Korean Medical Science · doi:10.3346/jkms.2025.40.e24 · Cited by 9
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Primary prevention of type 2 diabetes by lifestyle intervention in primary care setting
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“The primary aim of lifestyle interventions is to prevent or delay development of type 2 diabetes by targeting obesity and physical inactivity, the two most important modifiable risk factors of diabetes development.(11,13) The results of the American, Finish and Spanish preventive interventions indicate that intensive…”
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Prevention of Type 2 Diabetes Insulin Resistance and -Cell Function
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“Lifestyle interventions are effective for T2DM prevention in middle-aged adults, with the risk of diabetes being reduced by 46-58% [6, 7].”
BackgroundPerceived risk for diabetes among U.S. adults with undiagnosed prediabetes
Joiner, K. L., Adams, M. P., Lee, K. A., Piatt, G., & Davis, M. A. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107089 · Cited by 7
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“The mean BMI of participants in these studies was about 25-27 kg/m(2), and was lower than in Western populations, which was 31-34 kg/m(2).(21,22) A meta-analysis that compared insulin sensitivity and acute insulin response during frequent intravenous glucose tolerance tests in multiethnic groups revealed a higher insu…”
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Preservation of β-Cells as a Therapeutic Strategy for Diabetes
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“The Finnish Diabetes Prevention Study also showed a 58 % reduction in T2D incidence through lifestyle intervention, preserving β-cell function by improving insulin sensitivity [34].”
BackgroundKhoramipour, K., Rezaei, M. H., Moslemizadeh, A., Hosseini, M. S., Ebrahimnezhad, N., & Bashiri, H. (2024) · Behavioral and Brain Functions · doi:10.1186/s12993-024-00235-0 · Cited by 8
“Considering that lifestyle modification is recommended before pharmacologic therapy, exercise training is strongly recommended as a safe and easily available method [21, 22].”
MethodIoannou, E., Humphreys, H., Homer, C. V., & Purvis, A. J. (2024) · Maternal and Child Health Journal · doi:10.1007/s10995-024-03948-w · Cited by 9
“Lifestyle changes, including physical activity (PA) and dietary changes, have been shown to reduce onset of T2DM by over 50% (Knowler et al., 2002; Pan et al., 1997; Tuomilehto et al., 2001).”
Background
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
- Publisher
- Massachusetts Medical Society
- 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
- bronze
- doi.org
- 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 ›
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