Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: results from a randomized clinical trial.

Type 2 diabetes mellitus is increasing worldwide largely as a result from increasing obesity and sedentary lifestyle. The Finnish Diabetes Prevention Study (DPS) is the first individually randomized controlled clinical trial to test the feasibility and efficacy of lifestyle modification in high-risk subjects. We randomly assigned 522 (172 men, 350 women) middle-aged (mean age 55 yr), overweight (mean body mass index 31 kg/m(2)) subjects with impaired glucose tolerance either to the lifestyle intervention or control group. Each subject in the intervention group received individualized counseling aimed at reducing weight and intake of total and saturated fat, and increasing intake of fiber and physical activity. An oral glucose tolerance test was performed annually to detect incident cases of diabetes and to measure changes in metabolic parameters. The mean (+/- SD) weight reduction from baseline to year 1 and to year 2, respectively, was 4.2 +/- 5.1 kg and 3.5 +/- 5.5 in the intervention group and 0.8 +/- 3.7 kg and 0.8 +/- 4.4 in the control group (P < 0.001 between the groups). At the time of first analysis of the outcome data the mean duration of follow-up was 3.2 yr. The risk of diabetes was reduced by 58% (P < 0.001) in the intervention group compared with the control group. The reduction in the incidence of diabetes was directly associated with number and magnitude of lifestyle changes made. In conclusion, the DPS is the first controlled trial demonstrating that type 2 diabetes can be prevented by changes in lifestyle in high-risk subjects.

[1]  K. Eriksson,et al.  Prevention of Type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise The 6-year Malmö feasibility study , 1991, Diabetologia.

[2]  P. Björntorp,et al.  Risk factors for Type 2 (non-insulin-dependent) diabetes mellitus. Thirteen and one-half years of follow-up of the participants in a study of Swedish men born in 1913 , 1988, Diabetologia.

[3]  H. King,et al.  Primary prevention of Type 2 (non-insulin-dependent) diabetes mellitus , 2004, Diabetologia.

[4]  M. Uusitupa,et al.  Prevalence of coronary heart disease, left ventricular failure and hypertension in middle-aged, newly diagnosed Type 2 (non-insulin-dependent) diabetic subjects , 2004, Diabetologia.

[5]  M. Lankarani,et al.  PRIMARY PREVENTION OF TYPE 2 DIABETES MELLITUS , 2002 .

[6]  M. Laakso,et al.  Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial , 2002, The Lancet.

[7]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[8]  T. Valle,et al.  Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. , 2001, The New England journal of medicine.

[9]  S. Haffner,et al.  Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects: implications for preventing coronary heart disease during the prediabetic state. , 2000, Circulation.

[10]  E. Feskens,et al.  Glucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria , 1999, The Lancet.

[11]  T. Valle,et al.  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 , 1999, Diabetologia.

[12]  B. Howard,et al.  Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance: The Da Qing IGT and Diabetes Study , 1997, Diabetes Care.

[13]  E Mervaala,et al.  Natural history of peripheral neuropathy in patients with non-insulin-dependent diabetes mellitus. , 1995, The New England journal of medicine.

[14]  M. Harris,et al.  Undiagnosed NIDDM: Clinical and Public Health Issues , 1993, Diabetes Care.

[15]  J. Tuomilehto,et al.  Primary prevention of non-insulin-dependent diabetes mellitus. , 1992, Diabetes/metabolism reviews.

[16]  R. Hamman Genetic and environmental determinants of non-insulin-dependent diabetes mellitus (NIDDM). , 1992, Diabetes/metabolism reviews.

[17]  J. Manson,et al.  Physical activity and incidence of non-insulin-dependent diabetes mellitus in women , 1991, The Lancet.

[18]  M. Stern Kelly West Lecture: Primary Prevention of Type II Diabetes Mellitus , 1991, Diabetes Care.

[19]  P. Zimmet Primary Prevention of Diabetes Mellitus , 1988, Diabetes Care.

[20]  J. Neel Diabetes mellitus: a "thrifty" genotype rendered detrimental by "progress"? , 1962, American journal of human genetics.

[21]  Dang Qing,et al.  Effects of Diet and Exercise in Preventing NIDDM in People With Impaired Glucose Tolerance The , 2022 .