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The Finnish Diabetes Prevention Study

Published online by Cambridge University Press:  09 March 2007

Matti Uusitupa ,
Anne Louheranta ,
Jaana Lindström ,
Timo Valle ,
Jouko Sundvall ,
Johan Eriksson  and
Jaakko Tuomilehto
Matti Uusitupa*
Affiliation:
Department of Clinical Nutrition, University of Kuopio and Kuopio University Hospital, PO Box 1777, 70211, Kuopio, Finland
Anne Louheranta
Affiliation:
National Public Health Institute, Helsinki, Finland
Jaana Lindström
Affiliation:
National Public Health Institute, Helsinki, Finland
Timo Valle
Affiliation:
National Public Health Institute, Helsinki, Finland
Jouko Sundvall
Affiliation:
National Public Health Institute, Helsinki, Finland
Johan Eriksson
Affiliation:
National Public Health Institute, Helsinki, Finland
Jaakko Tuomilehto
Affiliation:
National Public Health Institute, Helsinki, Finland
*
*Corresponding author: M. Uusitupa, fax +358 17 172 116, email [email protected]
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Abstract

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The aim of the Finnish Diabetes Prevention Study is to assess the efficacy of an intensive diet–exercise programme in preventing or delaying type 2 diabetes in individuals with impaired glucose tolerance (IGT) and to evaluate the effect of the programme on the risk factors of atherosclerotic vascular diseases and the incidence of cardiovascular events. In this ongoing study, a total of 523 overweight subjects with IGT based on two oral glucose tolerance tests were randomized to either an intervention group or a control group. The main measure in the intervention group is individual dietary advice aimed at reducing weight and intake of saturated fat and increasing intake of dietary fibre. The intervention subjects are individually guided to increase their level of physical activity. The control group receives general information about the benefits of weight reduction, physical activity and healthy diet in the prevention of diabetes. A pilot study began in 1993, and recruitment ended in 1998. By the end of April 1999 there were 65 new cases of diabetes, 34 drop-outs and one death. The weight reduction was greater (-4.6 kg) at 1 year in the intervention group (n = 152) than in the control group (n = 143, -0.9 kg, P < 0.0001), and this difference was sustained in the second year of follow-up. At 1 year 43.4 % and at 2 years 41.8 % of the intervention subjects had achieved a weight reduction of at least 5 kg, while the corresponding figures for the control subjects were 14.0 and 12.0 % (P < 0.001 between the groups). At 1 year the intervention group showed significantly greater reductions in 2 h glucose, fasting and 2 h insulin, systolic and diastolic blood pressure, and serum triglycerides. Most of the beneficial changes in cardiovascular risk factors were sustained for 2 years. These interim results of the ongoing Finnish Diabetes Prevention Study demonstrate the efficacy and feasibility of the lifestyle intervention programme.

Keywords

Type 2 diabetesimpaired glucose tolerance: preventiondietexerciselifestyle
Type
Research Article
Information
British Journal of Nutrition , Volume 83 , Issue S1 , June 2000 , pp. S137 - S142
Copyright
Copyright © The Nutrition Society 2000

References

Amos, AF, McCarty, DJ, Zimmet, P (1997) The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabetes Medicine 14, S7-S85.3.0.CO;2-R>CrossRefGoogle Scholar
DeFronzo, RA (1997) Pathogenesis of type 2 diabetes: metabolic and molecular implications for identifying diabetes genes. Diabetes Reviews 5, 177–269.Google Scholar
Diabetes Prevention, Program Research Group (1999), The Diabetes prevention program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care 22, 623–634.CrossRefGoogle Scholar
Eriksson, KF, Lindgärde, E (1991) Prevention of Type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise: The 6-year Malmö feasibility study. Diabetologia 34, 891–898.CrossRefGoogle ScholarPubMed
Eriksson, J, Lindström, J, Valle, T, Aunola, S, Hämäläinen, H, Ilanne-Parikka, P, Keinänen-Kiukaanniemi, S, Laakso, M, Lauhkonen, M, Lehto, P, Lehtonen, A, Louheranta, A, Mannelin, M, Martikkala, V, Rastas, M, Sundvall, J, Turpeinen, A, Viljanen, T, Uusitupa, M, Tuomilehto, J (1999) Prevention of type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia 42, 793–801.CrossRefGoogle ScholarPubMed
Goldstein, DJ, Potvin, JH (1994) Long term weight loss: effect of pharmacological agents. American Journal of Clinical Nutrition 60, 647–657.CrossRefGoogle Scholar
Hales, CN, Barker, DJ, Clark, PM, Cox, LJ, Fall, C, Osmond, C, Winter, PD (1991) Fetal and infant growth and impaired glucose tolerance at age 64. British Medical Journal 303, 1019–1022.CrossRefGoogle ScholarPubMed
Hamman, RF (1992) Genetic and environmental determinants of non-insulin-dependent diabetes mellitus (NIDDM). Diabetes and Metabolic Reviews 8, 287–338.CrossRefGoogle ScholarPubMed
Hays, RD, Donald, Sherbourne, C, , Hazel, RM (1993) The RAND 36-Hem Health Survey 1.0. Health Economics 2, 217–227.CrossRefGoogle ScholarPubMed
Kannel, WB, McGee, DL (1979) Diabetes and cardiovascular disease. The Framingham study. Journal of the American Medical Association 241, 2035–2038.CrossRefGoogle ScholarPubMed
Knowler, WC, Narayan, KVM, Hanson, RL, Nelson, RG, Bennett, PH, Tuomilehto, J, Schersten, B, Pettitt, PH (1995) Preventing non-insulin-dependent diabetes mellitus. Diabetes 44, 483–488.CrossRefGoogle Scholar
Kuusisto, J, Mykkänen, L, Pyörälä, K, Laakso, M (1994) NIDDM and its metabolic control predict coronary heart disease in elderly subjects. Diabetes 43, 960–967.CrossRefGoogle ScholarPubMed
Laitinen, JH, Ahola, IE, Sarkkinen, ES, Winberg, RL, Harmaakorpi-Iivonen, PA, Uusitupa, MI (1993) Impact of intensified dietary therapy on energy and nutrient intakes and fatty acid composition of serum lipids in patients with recently diagnosed non-insulin-dependent diabetes mellitus. Journal of the American Dietetic Association 93, 276–283.CrossRefGoogle Scholar
Niskanen, L, Turpeinen, A, Penttilä, I, Uusitupa, MI (1998) Hyperglycemia and compositional lipoprotein abnormalities as predictors of cardiovascular mortality in type 2 diabetes: a 15-year follow-up from the time of diagnosis. Diabetes Care 21, 1861–1869.CrossRefGoogle ScholarPubMed
Pan, X-R, Li, G-W, Hu, Y-H, Wang, J-X, Yang, W-Y, An, Z-X, Hu, Z-X, Lin, J, Xiao, J-Z, Cao, H-B, Liu, P-A, Liang, X-G, Jiang, Y-Y, Wang, J-P, Zheng, H, Zhanf, H, Bennett, PH, Howard, BV (1997) Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 20, 537–544.CrossRefGoogle Scholar
Sarkkinen, ES, Schwab, US, Niskanen, LK, Hannuksela, ML, Savolainen, MJ, Kervinen, K, Kesäniemi, YA, Uusitupa, MIJ (1996) The effects of monounsaturated-fat enriched diet and polyunsaturaed-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. European Journal of Clinical Nutrition 50, 592–598.Google ScholarPubMed
Shepherd, PR, Kahn, BB (1999) Glucose transporters and insulin action. New England Journal of Medicine 341, 248–257.CrossRefGoogle ScholarPubMed
Sjöström, L, Rissanen, A, Andersen, T, Boldrin, M, Golay, A, Koppenschaar, PF, Kremmpf, M (1998) Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. Lancet 352, 167–173.CrossRefGoogle ScholarPubMed
Pyörälä, K, Laakso, M, Uusitupa, M (1987) Diabetes and atherosclerosis: an epidemiologic view. Diabetes and Metabolic Reviews 3, 463–524.CrossRefGoogle ScholarPubMed
Tuomilehto, JTuomilehto-Wolf, EZimmet, PAlberti, KGMMKnowler, WC (1997) Primary prevention of diabetes mellitus. In International Textbook of Diabetes Mellitus, 2nd edn, pp. 1799–1827 [KGMM, Alberti, P, Zimmet, RA, DeFronzo, H, Keen, editors]. Chichester, UK: Wiley.Google Scholar
Uusitupa, MIJ (1996) Early lifestyle intervention in patients with non-insulin-dependent diabetes mellitus and impaired glucose tolerance. Annals of Medicine 28, 445–449.CrossRefGoogle ScholarPubMed
Uusitupa, MIJ, Niskanen, LK, Voutilainen, E, Pyörälä, K (1993) Ten-year cardiovascular mortality in relation to risk factors and abnormalities in lipoprotein composition in type 2 (non-insulin-dependent) diabetic and non-diabetic subjects. Diabetologia 36, 1175–1184.CrossRefGoogle ScholarPubMed
Uusitupa, M, Laakso, M &, Pyörälä, K (1997) Metabolic control and macrovascular disease. In International Textbook of Diabetes Mellitus, 2nd edn [KGMM, Alberti, P, Zimmet, RA, DeFronzo, H, Keen, editors]. Chichester, UK: Wiley.Google Scholar
WHO (1985) Diabetes Mellitus. Technical Report SeriesGeneva, Switzerland:World Health Organization.Google Scholar