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Cited by 302Diabetes, Cardiovascular Risks, and LipoproteinsDiabetes Management and EducationDiabetes Treatment and Management

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

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Saaristo, Timo, Moilanen, Leena, Korpi-Hyövälti, Eeva, Vanhala, Mauno, Saltevo, Juha, Niskanen, Leo, Jokelainen, Jari, Peltonen, Markku +4 more·2010·Diabetes Care
DOI 10.2337/dc10-0410PMC PMC2945150
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Abstract

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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  • Diet and lifestyle modification and medicines in people at high risk of diabetes (including those with prediabetes) can prevent or delay diabetes onset and reduce the risk of some complications.

    “Alongside these population-based measures, diet and lifestyle modification and medicines in people at a high risk of diabetes (including those with prediabetes) can prevent or delay diabetes onset and reduce the risk of some complications.48–55”

    From Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants (2024) · cites this paper as [49]

    The Conclusions report that lifestyle changes can prevent or postpone type 2 diabetes in high-risk people and describe a shorter-lived preventive effect of drug treatment. The Results report improvements in blood pressure and lipid levels with weight loss, but do not establish a reduced risk of diabetes complications; risk-factor changes are not complication outcomes. (LLM, conf=0.86)

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  • In countries with universal health insurance and good access to primary care, people at high risk of diabetes might be identified early and advised to use a combination of diet and lifestyle modifications and medicines to prevent or delay diabetes onset.

    “In countries with universal health insurance and good access to primary care, people at a high risk of diabetes might also be identified early and advised to use a combination of diet and lifestyle modifications and medicines to prevent or delay diabetes onset.48–55”

    From Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants (2024) · cites this paper as [49]

    The Research Design and Methods section (page unavailable) describes identifying high-risk people in Finnish primary care and counseling them on diet and other lifestyle changes. The paper does not describe advising them to combine those changes with medicines to prevent diabetes, nor does it establish that the approach applies specifically to countries with universal health insurance. Its discussion contrasts the lasting effects of lifestyle intervention with the rapidly vanishing preventive effect of drug treatment. (LLM, conf=0.87)

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Research works printed but not linked: 18

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Authors
Saaristo, T., Moilanen, L., Korpi-Hyövälti, E., Vanhala, M., Saltevo, J., Niskanen, L., Jokelainen, J., Peltonen, M., Oksa, H., Tuomilehto, J., Uusitupa, M., & Keinänen-Kiukaanniemi, S.
Affiliations
  • Finnish Diabetes Association (FI)
  • Kuopio University Hospital (FI)
  • Department on Internal Medicine, South Ostrobothnia Hospital District, Seinäjoki, Finland;
  • University of Eastern Finland (FI)
  • Central Finland Health Care District (FI)
  • University of Oulu (FI)
  • Finnish Institute for Health and Welfare (FI)
  • Pirkanmaa Hospital District (FI)
  • University of Helsinki (FI)
  • University of Oulu, Institute of Health Sciences, Faculty of Medicine, Oulu, Finland;
Corresponding author
Moilanen, Leena
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2010-07-27
Volume
33
Issue
10
Pages
2146-2151
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc10-0410
PMC
PMC2945150
OpenAlex
W2170860972
Cited by
302
References
4
Citations by year
2026: 7 · 2025: 4 · 2024: 7 · 2023: 8 · 2022: 12 · 2021: 21 · 2020: 24 · 2019: 18 · 2018: 16 · 2017: 20 · 2016: 18 · 2015: 21 · 2014: 21 · 2013: 29 · 2012: 36
FWCI
25.15
Type
journal article
Language
en
Open access
Licence
Locations
Diabetes Care (publishedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
type 2 diabetes prevention, lifestyle intervention, FINDRISC, impaired fasting glucose, impaired glucose tolerance, weight loss, high-risk individuals, primary care, national prevention program, diabetes incidence

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