The effectiveness of a community-based, type 2 diabetes prevention programme on health-related quality of life. The DE-PLAN study

Abstract

Background and aimsThe DE-PLAN was a European multicenter study, with the primary objective of testing whether a community-based lifestyle modification programme could serve as a means of primary prevention for type 2 diabetes (T2D) in high-risk individuals (based on the FINDRISC questionnaire). The aim of this study was to examine the impact of a 1-year community-based lifestyle intervention on health-related quality of life (HRQOL) in individuals from four participating European centers (Athens, Barcelona, Krakow, Kaunas), through a post-hoc analysis.Materials and methodsEach center was allowed to implement different intervention strategies specifically tailored to the needs of their corresponding population sample. Before and after the intervention, participants underwent clinical evaluation, anthropometric measurements, an oral glucose tolerance test and lipid profile measurements. Health-related quality of life was assessed using the validated HRQOL-15D questionnaire. A difference of ±0.015 in the 15D questionnaire score was set as the threshold of clinically meaningful change.ResultsData from 786 participants (67% females, mean age 59.7±9.4 years, BMI 31.5±4.5 kg/m2) with complete data regarding the HRQOL were analyzed (Athens: 104, Barcelona: 434, Krakow: 175, Kaunas: 70). After 1 year, a significant overall improvement in HRQOL was shown, as depicted by a change of 15D score from baseline value (0.88±0.9) to post-intervention (0.90±0.87, P<0.001), achieving the threshold of clinically meaningful change. A significant weight reduction was also observed (-0.8±4.0 kg, P<0.001). In multivariate analysis, improvement in HRQOL was independently associated with lower 15D score at baseline (P<0.001) and self-reported increase in overall exercise time (P<0.001) as assessed through specifically designed trial questionnaires.ConclusionA community-based lifestyle intervention programme aiming at T2D prevention, applied on a heterogeneous population and with varied methods, was shown to improve overall health-related quality of life to a clinically meaningful degree.

Association between TUG and Anthropometric Values, Vibration Perception Threshold, FHSQ and 15-D in Type 2 Diabetes Mellitus Patients

“…DM complications, such as diabetic neuropathy [3], may affect health-related quality of life (HRQoL). One instrument to assess the HRQoL in T2DM patients [4,5] is the 15-D questionnaire, which consists of 15 sections. In addition, it is important to know the foot health status of patients, that may be measured using different tools.…”

Report from an effort to prevent type 2 diabetes development in primary care

“…Just recently, results were published concerning a positive effect on quality of life [11], but no aggregated results from the study have been reported so far. However, some centres have reported local results from the intervention [11][12][13][14], and the results are clearly related to the intensity of the intervention, showing that the more resources, the more effective the intervention [12]. To help and support individuals with prediabetes in primary care, thus, a more intense intervention than group sessions seems to be needed.…”

“…The most ambitious diabetes prevention programme was initiated in Finland through the "Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional Intervention", i.e., the DE-plan, where different European countries are testing whether the DPS can be implemented in existing health care systems [10]. Just recently, results were published concerning a positive effect on quality of life [11], but no aggregated results from the study have been reported so far. However, some centres have reported local results from the intervention [11][12][13][14], and the results are clearly related to the intensity of the intervention, showing that the more resources, the more effective the intervention [12].…”

The Influence of Hypoglycemia on the Specific Quality of Life in Type 2 Diabetes Mellitus: a Comparative Cross-sectional Study of Diabetics With and Without Hypoglycemia in Xi'an, China

“…Therefore, given that diabetes being with such high incidence rate and mortality worldwide, especially in China [42,43] and hypoglycemia had such serious adverse effects on the diabetics' living quality, effective approaches must been taken, particularly the measurements of decreasing the risk of iatrogenic hypoglycemia. On the one hand, medical staff should carry out health education on diabetes [44], which can learn from Karamanakos's [45] advocacy of community-based intervention for diabetes to carry out one-to-one guidance to strengthen blood glucose management and reduce the incidence of hypoglycemia. On the other hand, doctors should strengthen the screening of anxiety and depression in diabetics [46].…”