Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects.

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OBJECTIVE -To describe the 1) lifestyle intervention used in the Finnish Diabetes Prevention Study, 2) short-and long-term changes in diet and exercise behavior, and 3) effect of the intervention on glucose and lipid metabolism.RESEARCH DESIGN AND METHODS -There were 522 middle-aged, overweight subjects with impaired glucose tolerance who were randomized to either a usual care control group or an intensive lifestyle intervention group. The control group received general dietary and exercise advice at baseline and had an annual physician's examination. The subjects in the intervention group received additional individualized dietary counseling from a nutritionist. They were also offered circuit-type resistance training sessions and advised to increase overall physical activity. The intervention was the most intensive during the first year, followed by a maintenance period. The intervention goals were to reduce body weight, reduce dietary and saturated fat, and increase physical activity and dietary fiber.RESULTS -The intervention group showed significantly greater improvement in each intervention goal. After 1 and 3 years, weight reductions were 4.5 and 3.5 kg in the intervention group and 1.0 and 0.9 kg in the control group, respectively. Measures of glycemia and lipemia improved more in the intervention group.CONCLUSIONS -The intensive lifestyle intervention produced long-term beneficial changes in diet, physical activity, and clinical and biochemical parameters and reduced diabetes risk. This type of intervention is a feasible option to prevent type 2 diabetes and should be implemented in the primary health care system. Diabetes Care 26:3230 -3236, 2003T he Finnish Diabetes Prevention Study (DPS) was one of the first controlled, randomized studies to show that type 2 diabetes is preventable with lifestyle intervention (1). The risk of diabetes was reduced by 58% in the intensive lifestyle intervention group compared with the control group. These results have been reproduced by the Diabetes Prevention Program (DPP), in which lifestyle intervention, with a similar 58% risk reduction, was superior to the metformin treatment (2). The lifestyle intervention used in the DPP was not designed to be used in community settings (3), whereas one of the main objectives in the DPS was to test an intervention feasible in primary health care.In this study, we describe the lifestyle intervention program used in the DPS, the changes in dietary habits and exercise behavior that were achieved during the first year and the maintenance of these changes after 3 years, and assess the efficacy of the intervention on body weight, plasma glucose, and lipids. RESEARCH DESIGN AND METHODS -The DPS was a multicenter study with five participating centers in Helsinki, Kuopio, Turku, Tampere, and Oulu. The study protocol was approved by the ethics committee of the National Public Health Institute in Helsinki, Finland. Each study center employed a physician, study nurse, and nutritionist (MSc in nutrition) on a part-time basis. Either an exerci...

Insulin resistance is central for the aetiology of the metabolic syndrome cluster of disease: blood lipid disorders, hypertension, propensity for thrombus formation, abdominal obesity and Type II (insulin-dependent) diabetes mellitus [1]. Although genetic predisposition is a factor, the prevalence of obesity and diabetes is increasing rapidly in both developed and developing countries [2] arguing that lifestyle factors such as dietary and physical activity patterns, which are amenable to change, modulate insulin action and hence disease development.Experimental and clinical data suggest that the amount and quality of fat in the diet could be important for the development of insulin resistance and related metabolic disorders [3]. A high proportion of Diabetologia (2001) AbstractAims/hypothesis. The amount and quality of fat in the diet could be of importance for development of insulin resistance and related metabolic disorders. Our aim was to determine whether a change in dietary fat quality alone could alter insulin action in humans. Methods. The KANWU study included 162 healthy

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