Saaristo Timo, Peltonen Markku, Keinänen-Kiukaanniemi Sirkka, Vanhala Mauno, Saltevo Juha, Niskanen Leo, Oksa Heikki, Korpi-Hyövälti Eeva, Tuomilehto Jaakko
Finnish Diabetes Association, Tampere, Finland.
Int J Circumpolar Health. 2007 Apr;66(2):101-12. doi: 10.3402/ijch.v66i2.18239.
Current evidence shows that type 2 diabetes (T2D) can be prevented by life-style changes and medication. To meet the menacing diabetes epidemic, there is an urgent need to translate the scientific evidence regarding prevention of T2D into daily clinical practice and public health. In Finland, a national programme for the prevention of T2D has been launched. The programme comprises 3 concurrent strategies for prevention: the population strategy, the high-risk strategy and the strategy of early diagnosis and management. The article describes the implementation strategy for the prevention programme for T2D.
The implementation project, FIN-D2D, is being conducted in 5 hospital districts, covering a population of 1.5 million, during the years 2003-2007. The main actors in the FIN-D2D are primary and occupational health care providers.
The goals of the project are (1) to reduce the incidence and prevalence of T2D and prevalence of cardiovascular risk factor levels; (2) to identify individuals who are unaware of their T2D; (3) to generate regional and local models and programmes for the prevention of T2D; (4) to evaluate the effectiveness, feasibility and costs of the programme; and (5) to increase the awareness of T2D and its risk factors in the population and to support the population strategy of the diabetes prevention programme. The feasibility, effectiveness and costs of the programme will be evaluated according to a specific evaluation plan.
Current research evidence shows that the type 2 diabetes can be effectively prevented in high-risk subjects by life-style changes, which include increased physical activity and weight reduction. FIN-D2D explores ways to implement these methods on a national level.
目前的证据表明,2型糖尿病(T2D)可通过生活方式改变和药物治疗来预防。为应对严峻的糖尿病流行趋势,迫切需要将有关T2D预防的科学证据转化为日常临床实践和公共卫生措施。在芬兰,已启动一项全国性的T2D预防计划。该计划包括3项并行的预防策略:人群策略、高危人群策略以及早期诊断和管理策略。本文描述了T2D预防计划的实施策略。
实施项目FIN-D2D于2003年至2007年在5个医院辖区开展,覆盖人口达150万。FIN-D2D的主要参与者是初级和职业卫生保健提供者。
该项目的目标是:(1)降低T2D的发病率和患病率以及心血管危险因素水平的患病率;(2)识别未意识到自己患有T2D的个体;(3)生成区域和地方层面的T2D预防模式和计划;(4)评估该计划的有效性、可行性和成本;(5)提高人群对T2D及其危险因素的认识,并支持糖尿病预防计划的人群策略。将根据具体的评估计划对该计划的可行性、有效性和成本进行评估。
目前的研究证据表明,通过生活方式改变,包括增加体育活动和减轻体重,可在高危人群中有效预防2型糖尿病。FIN-D2D探索在国家层面实施这些方法的途径。