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Randomized Controlled Trial
. 2011 Jan 17;11(1):40.
doi: 10.1186/1471-2458-11-40.

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

Naoki Sakane  1 , Juichi Sato, Kazuyo Tsushita, Satoru Tsujii, Kazuhiko Kotani, Kokoro Tsuzaki, Makoto Tominaga, Shoji Kawazu, Yuzo Sato, Takeshi Usui, Isao Kamae, Toshihide Yoshida, Yutaka Kiyohara, Shigeaki Sato, Hideshi Kuzuya; Japan Diabetes Prevention Program (JDPP) Research Group
Collaborators, Affiliations
Randomized Controlled Trial

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

Naoki Sakane et al. BMC Public Health. .

Abstract

Background: A 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.

Methods: Through 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.

Results: After 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).

Conclusions: The 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 number: UMIN000003136.

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Figures

Figure 1
Figure 1
Recruitment, random assignment, and 3 - year follow-up of study subjects. DM: diabetes mellitus, IFG: impaired fasting glucose, NGT: normal glucose tolerance
Figure 2
Figure 2
Cumulative incidence of diabetes over the three years in all participants. Kaplan-Meier plots. Intervention group (black circle) and Control group (black triangle).
See this image and copyright information in PMC

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