Endocrine Abstracts

Background: Real life implementation studies performed in different settings/populations proved that lifestyle interventions in prevention of DM2 can be effective. However, little is known about long term results of these translational studies and determinants of the outcomes.

Aim: The purpose of this study was to examine the maintenance of diabetes type 2 risk factor during 3 year follow-up and to examine determinants of long term outcomes.

Methods: Study participants (n=263), middle-aged, slightly obese with baseline increased DM2 risk (FINDRISC)>14), but no baseline diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. Examinations were performed baseline, after one/three years. Repeated measure analysis was used for comparison of the 3 measurements. Stepwise regression analysis was used to determine predictors of weight reduction maintenance.

Results: Mean weight decreased by 2.27 kg (S.D.=5.25) after 1 year (P=<0.001), the mean total weight loss at the end of the study was maintained by 1.14 kg (S.D.=5.8) (ns). 70% of participants showed weight loss during the intervention (mean weight loss 4.2 kg, S.D.=5.1), 37% maintained weight loss during the 3 year follow-up(mean weight loss 2.1 kg, S.D.=2.3) In repeated measures analysis significant changes were observed from baseline to year 1 and year 3 in: weight (P=0.048), BMI (P=0.001), total cholesterol (P=0.013), TG (P=0.061), fasting glucose level (P=0.037) and FINDRISC (P=0.001) parameters. The conversion rate to diabetes was 2% after 1 year and 7% after 3 years. In multivariate analysis baseline history of increased glucose (odds ratio (OR)=3.7; 95% confidence interval (CI) 1.0–13.6) and reduction of total fat in diet during follow-up (OR=4.3; 95% CI 1.5–12.2) were independent predictors of successful weight loss maintains during follow up.

Conclusions: Type 2 diabetes prevention in real life primary health care setting through lifestyle intervention delivered by trained nurses leads to long term modest weight reduction and decrease of diabetes risk. Further studies exploring predictors of success are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.