Importance of weight loss maintenance and risk prediction in the prevention of type 2 Diabetes: analysis of European Diabetes Prevention Study RCT

L. Penn, M. White, J. Lindström, A.Th. den Boer, E.E. Blaak, J.G. Eriksson, E.J.M. Feskens, P. Ilanne-Parikka, S.M. Keinanen-Kiukaanniemi, M. Walker, J.C. Mathers, M. Uusitupa, J. Tuomilehto

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Abstract

Background Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial cohorts: to analyse T2D incidence, sustained weight loss and utility of risk predictors. Methods We analysed data on 749 adults with impaired glucose tolerance (278 men and 471 women, mean age 56 years, mean BMI 31 kgm-2) recruited between 1993 and 2003, and randomised to intensive lifestyle intervention (I) or lifestyle advice control (C). The intervention aimed to increase physical activity, modify diet, and promote weight loss=5%. Using Cox-regression survival analysis, we assessed T2D incidence and the impact on T2D incidence of sustained weight loss, and of baseline cut-point values of FINDRISC score, fasting plasma glucose (FPG), and HbA1c. Results Mean follow-up duration was 3.1 years. T2D was diagnosed in 139 participants (I = 45/379, C = 94/370). Cumulative T2D incidence was 57% lower in the intervention compared with the control group (HR 0.42 (95% CI 0.29 to 0.60) P
Original languageEnglish
Article numbere57143
Number of pages11
JournalPLoS ONE
Volume8
Issue number2
DOIs
Publication statusPublished - 2013

Keywords

  • life-style intervention
  • impaired glucose-tolerance
  • follow-up
  • program
  • trial
  • mellitus
  • behavior
  • fin-d2d
  • obesity
  • adults

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    Penn, L., White, M., Lindström, J., den Boer, A. T., Blaak, E. E., Eriksson, J. G., Feskens, E. J. M., Ilanne-Parikka, P., Keinanen-Kiukaanniemi, S. M., Walker, M., Mathers, J. C., Uusitupa, M., & Tuomilehto, J. (2013). Importance of weight loss maintenance and risk prediction in the prevention of type 2 Diabetes: analysis of European Diabetes Prevention Study RCT. PLoS ONE, 8(2), [e57143]. https://doi.org/10.1371/journal.pone.0057143