Intensive intervention on lifestyle from primary care takes the incidence of diabetes.
project of PLAN (Diabetes in Europe-Prevention using Lifestyle, Physical Activity and Nutritional-intervention) applied in Catalonia, through the area of Diabetes and diseases Endocrino-Metabólicas of the IDIAP Jordi Gol, demonstrates for the first time in Europe the effectiveness of an intervention on lifestyle during clinical practice in primary care because it substantially reduces the incidence of diabetes type 2 among participants with high risk.
Spain, February 2012. The project PLAN-CAT / predicts, the Catalonia of the European project of PLAN implementation, it has consisted of a prospective cohort in primary care study. He was a dual and sequential screening in non-diabetic subjects of 45 to 75 years, first through the questionnaire FINDRISC (8 items by analyzing the future risk of diabetes) and, second, with a test of oral tolerance to glucose (PTOG). The study has been carried out since the unit Suport a la Recerca (USR) that IDIAP Jordi Gol is in Reus and Tarragona, with the participation of primary care centres distributed throughout Catalonia.
Participants with high risk although free of diabetes were assigned consecutively to a standardised intervention or intensive intervention PLAN on the lifestyle (individual or group). Both groups were followed, first with conventional measures and the second by personal periodic reinforcement of their motivation. The primary indicator of effectiveness was the development of diabetes at age 4 (who criteria).
Contacted 2.547 certain users randomly among the population assigned to primary care centres, of whom 2,054 (80.6 per cent) replying to the questionnaire and 1.192 (58%) agreed in addition proof of oral tolerance to glucose (PTOG). High risk of diabetes was detected in 624 users, either by FINDRISC (n = 347), PTOG (n = 106) or both tests (n = 171).
Finally, 552 users accepted the intervention by assigning 219 (39.7%) the standardized model and 333 (60.3%) to the intensive intervention. Both groups were comparable in age, gender, BMI, score in FINDRISC (16.2/15.8), the indicators glucémicos as well as the interest in making changes in your lifestyle.
Results
It was diagnosed with diabetes to 124 participants, of whom 63 (28.8%) in standard intervention and 61 (18.3%) in intensive intervention. During a median of 4.2 years, diabetes incidence was 7.2 and 4.6 cases per 100 persons per year, respectively, reducing 36% relative risk of developing diabetes in the intensive intervention with respect to conventional intervention group.
The necessary number of participants to treat during 4 years to reduce a case of diabetes was 9.5. The intensive intervention had a significant protective effect on the incidence of diabetes in all analyzed multivariate models.
According to Dr. Bernardo Costa, Coordinator of the Group of investigation of-PLANCat /PREDICE in the area of Diabetes and diseases Endocrino-Metabólicas the Institute of research in primary care (IDIAP Jordi Gol) these results are very valuable because they show that carrying out an intensive intervention on well structured lifestyle not only is feasible in primary care but It substantially reduces the incidence of diabetes among participants with high risk. This experience can show the way forward to other initiatives that are trying to develop in other countries and reinforces the theoretical idea that diabetes type 2 can be prevented through perfectly affordable changes in lifestyle ”.
The full study will be published in the journal Diabetologia.
what is the IDIAP?
The Foundation Jordi Gol i Gurina was created in 1996 by the Catalan Health Institute, with the aim of promoting and managing innovation, training, teaching and research clinical, epidemiological and health services in the field of primary health care.
In 2006, it became the Institute for research in primary care Jordi Gol (IDIAP Jordi Gol), through the signing of an economic agreement with the Department of health and the Autonomous University of Barcelona.
From 2010 it is attached to the UAB as Instituto Universitario de Investigación en Atención Primaria.
From August 2011 has the quality certification ISO 9001: 2008 for its activities of support and advice to project research.
