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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

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

Authors: Naoki Sakane, 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 the for

Published in: BMC Public Health | Issue 1/2011

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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
Appendix
Available only for authorised users
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Metadata
Title
Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance
Authors
Naoki Sakane
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 the for
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-40

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