Kilkkinen Annamari, Heistaro Sami, Laatikainen Tiina, Janus Edward, Chapman Anna, Absetz Pilvikki, Dunbar James
Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, Victoria, Australia.
Diabetes Res Clin Pract. 2007 Jun;76(3):460-2. doi: 10.1016/j.diabres.2006.09.027. Epub 2006 Oct 27.
Although clinical trials have shown that lifestyle modifications reduce the risk of type 2 diabetes, translating lessons from trials to primary care remains a challenge. The aim of the study was to evaluate efficacy and feasibility of primary care-based diabetes prevention model with modest resource requirements in rural Australia. Three hundred and eleven subjects with at least a moderate risk of type 2 diabetes participated in a combined dietary and physical activity intervention. Clinical measurements and fasting blood samples were taken at the baseline and after intervention. After 3 months intervention, total (change -3.5%, p<0.001) and LDL cholesterol (-4.8%, p<0.001) plasma levels as well as body mass index (-2.5%, p<0.001), weight (-2.5%, p<0.001), and waist (-1.6%, p<0.001) and hip (-2.7%, p<0.001) circumferences reduced significantly. A borderline reduction was found in triglyceride levels (-4.8%, p=0.058) while no changes were observed in HDL cholesterol (+0.6%, p=0.525), glucose (+0.06%, p=0.386), or systolic (-0.98%, p=0.095) or diastolic (-1.06%, p=0.134) blood pressure levels. In conclusion, a lifestyle intervention improved health outcomes - especially obesity and blood lipids - in a population at high risk of developing type 2 diabetes. Our results suggest that the present model is effective and feasible to carry out in primary care settings.
尽管临床试验表明生活方式的改变可降低2型糖尿病的风险,但将试验经验应用于初级保健仍然是一项挑战。本研究的目的是评估在澳大利亚农村地区资源需求适度的基于初级保健的糖尿病预防模式的有效性和可行性。311名至少有中度2型糖尿病风险的受试者参与了饮食和体育活动相结合的干预。在基线和干预后进行了临床测量和空腹血样采集。经过3个月的干预,血浆总胆固醇水平(变化-3.5%,p<0.001)、低密度脂蛋白胆固醇水平(-4.8%,p<0.001)、体重指数(-2.5%,p<0.001)、体重(-2.5%,p<0.001)、腰围(-1.6%,p<0.001)和臀围(-2.7%,p<0.001)均显著降低。甘油三酯水平有临界降低(-4.8%,p=0.058),而高密度脂蛋白胆固醇(+0.6%,p=0.525)、血糖(+0.06%,p=0.386)、收缩压(-0.98%,p=0.095)或舒张压(-1.06%,p=0.134)水平无变化。总之,生活方式干预改善了2型糖尿病高危人群的健康结局,尤其是肥胖和血脂情况。我们的结果表明,目前的模式在初级保健环境中实施是有效且可行的。