Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

BMC Public Health

Research Article

Shigeaki Sato¹  Kazuyo Tsushita²  Toshihide Yoshida³  Shoji Kawazu⁴  Juichi Sato⁵  Yuzo Sato⁶  Yutaka Kiyohara⁷  Satoru Tsujii⁸  Takeshi Usui⁹  Makoto Tominaga^1,10  Naoki Sakane^1,11  Kokoro Tsuzaki^1,11  Kazuhiko Kotani^1,12  Isao Kamae^1,13  Hideshi Kuzuya^1,14 

[1] Aino Hospital, Ibaraki, Japan;Comprehensive Health Science Center, Aichi Health Promotion Foundation, Aichi, Japan;Department of Diabetes and Metabolism, Kyoto City Hospital, Kyoto, Japan;Department of Diabetes and Metabolism, Marunouchi Hospital, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan;Department of General Medicine, Nagoya University Hospital, Nagoya, Japan;Department of Health Science, Faculty of Psychological and Physical Science, Aichi Gakuin University, Aichi, Japan;Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan;Diabetes Center, Tenri Yorozu-sodansho Hospital, Tenri, Japan;Division of Endocrinology, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan;Division of Internal Medicine, Hananoki Hospital, Tochigi, Japan;Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan;Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan;Department of Clinical Laboratory Medicine, Jichi Medical School, Tochigi, Japan;JPMA Pharmacoeconomics Program, Graduate School of Health Management, Keio University, Fujisawa, Japan;National Hospital Organization Kyoto Medical Center, Kyoto, Japan;Higashiyama Takeda Hospital, Kyoto, Japan;

关键词: Impaired Glucose Tolerance;    Lifestyle Intervention;    Leisure Time Physical Activity;    Diabetes Prevention Program;    Study Nurse;   

DOI  :  10.1186/1471-2458-11-40

 received in 2010-07-27, accepted in 2011-01-17,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized.MethodsThrough health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI) of 24.5 kg/m2 were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group.ResultsAfter 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023) and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045). Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097). In a sub-analysis for the subjects with a BMI > 22.5 kg/m2, a significant reduction in the cumulative incidence was found (p = 0.027).ConclusionsThe present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention.Trial registration numberUMIN000003136

【 授权许可】

CC BY   
© Sakane et al; licensee BioMed Central Ltd. 2011