University of Tilburg, Tilburg,the Netherlands.
Diabetes Care. 2011 Sep;34(9):1919-25. doi: 10.2337/dc10-2293. Epub 2011 Jul 20.
OBJECTIVE To study the overall effect of the Active Prevention in High-Risk Individuals of Diabetes Type 2 in and Around Eindhoven (APHRODITE) lifestyle intervention on type 2 diabetes risk reduction in Dutch primary care after 0.5 and 1.5 years and to evaluate the variability between general practices. RESEARCH DESIGN AND METHODS Individuals at high risk for type 2 diabetes (Finnish Diabetes Risk Score ≥13) were randomly assigned into an intervention group (n = 479) or a usual-care group (n = 446). Comparisons were made between study groups and between general practices regarding changes in clinical and lifestyle measures over 1.5 years. Participant, general practitioner, and nurse practitioner characteristics were compared between individuals who lost weight or maintained a stable weight and individuals who gained weight. RESULTS Both groups showed modest changes in glucose values, weight measures, physical activity, energy intake, and fiber intake. Differences between groups were significant only for total physical activity, saturated fat intake, and fiber intake. Differences between general practices were significant for BMI and 2-h glucose but not for energy intake and physical activity. In the intervention group, the nurse practitioners' mean years of work experience was significantly longer in individuals who were successful at losing weight or maintaining a stable weight compared with unsuccessful individuals. Furthermore, successful individuals more often had a partner. CONCLUSIONS Risk factors for type 2 diabetes could be significantly reduced by lifestyle counseling in Dutch primary care. The small differences in changes over time between the two study groups suggest that additional intervention effects are modest. In particular, the level of experience of the nurse practitioner and the availability of partner support seem to facilitate intervention success.
研究在荷兰初级保健中，艾恩德霍芬高危 2 型糖尿病主动预防（APHRODITE）生活方式干预对降低 2 型糖尿病风险的总体效果，评估普通诊所之间的变异性。
将芬兰糖尿病风险评分（Finnish Diabetes Risk Score）≥13 的 2 型糖尿病高危个体随机分为干预组（n = 479）或常规护理组（n = 446）。比较两组在 1.5 年内临床和生活方式措施的变化，比较两组和两组之间的变化。比较体重减轻或体重稳定者与体重增加者的个体特征、全科医生和护士从业者特征。
两组血糖值、体重测量值、体力活动、能量摄入和纤维摄入量均有适度变化。组间差异仅在总体力活动、饱和脂肪摄入和纤维摄入方面具有统计学意义。普通诊所之间的差异在 BMI 和 2 小时血糖方面显著，但在能量摄入和体力活动方面不显著。在干预组中，体重减轻或稳定的个体的护士从业者平均工作年限明显长于不成功的个体。此外，成功的个体更有可能有伴侣。
荷兰初级保健中通过生活方式咨询可以显著降低 2 型糖尿病的风险因素。两组在随时间变化的差异较小，表明额外的干预效果适中。特别是，护士从业者的经验水平和伴侣支持的可用性似乎促进了干预的成功。
