Lindström Jaana, Ilanne-Parikka Pirjo, Peltonen Markku, Aunola Sirkka, Eriksson Johan G, Hemiö Katri, Hämäläinen Helena, Härkönen Pirjo, Keinänen-Kiukaanniemi Sirkka, Laakso Mauri, Louheranta Anne, Mannelin Marjo, Paturi Merja, Sundvall Jouko, Valle Timo T, Uusitupa Matti, Tuomilehto Jaakko
Diabetes Unit, Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Mannerheimintie 166, 00300 Helsinki, Finland.
Lancet. 2006 Nov 11;368(9548):1673-9. doi: 10.1016/S0140-6736(06)69701-8.
Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, at least as long as the intervention continues. In the extended follow-up of the Finnish Diabetes Prevention Study, we assessed the extent to which the originally-achieved lifestyle changes and risk reduction remain after discontinuation of active counselling.
Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomly assigned to intensive lifestyle intervention or control group. After a median of 4 years of active intervention period, participants who were still free of diabetes were further followed up for a median of 3 years, with median total follow-up of 7 years. Diabetes incidence, bodyweight, physical activity, and dietary intakes of fat, saturated fat, and fibre were measured.
During the total follow-up, the incidence of type 2 diabetes was 4.3 and 7.4 per 100 person-years in the intervention and control group, respectively (log-rank test p=0.0001), indicating 43% reduction in relative risk. The risk reduction was related to the success in achieving the intervention goals of weight loss, reduced intake of total and saturated fat and increased intake of dietary fibre, and increased physical activity. Beneficial lifestyle changes achieved by participants in the intervention group were maintained after the discontinuation of the intervention, and the corresponding incidence rates during the post-intervention follow-up were 4.6 and 7.2 (p=0.0401), indicating 36% reduction in relative risk.
Lifestyle intervention in people at high risk for type 2 diabetes resulted in sustained lifestyle changes and a reduction in diabetes incidence, which remained after the individual lifestyle counselling was stopped.
生活方式干预可预防糖耐量受损发展为2型糖尿病，至少在干预持续期间如此。在芬兰糖尿病预防研究的延长随访中，我们评估了主动咨询停止后，最初实现的生活方式改变和风险降低能在多大程度上得以维持。
将糖耐量受损的超重中年男性（n = 172）和女性（n = 350）随机分配至强化生活方式干预组或对照组。在中位4年的主动干预期后，仍未患糖尿病的参与者进一步随访中位3年，总随访中位时间为7年。测量糖尿病发病率、体重、身体活动以及脂肪、饱和脂肪和纤维的饮食摄入量。
在整个随访期间，干预组和对照组2型糖尿病的发病率分别为每100人年4.3例和7.4例（对数秩检验p = 0.0001），相对风险降低43%。风险降低与实现体重减轻、总脂肪和饱和脂肪摄入量减少、膳食纤维摄入量增加以及身体活动增加等干预目标的成功情况相关。干预组参与者实现的有益生活方式改变在干预停止后得以维持，干预后随访期间相应的发病率分别为4.6例和7.2例（p = 0.0401），相对风险降低36%。
对2型糖尿病高危人群进行生活方式干预可带来持续的生活方式改变并降低糖尿病发病率，在个体生活方式咨询停止后这种效果依然存在。
