Department of Public Health Solutions, National Institute for Health and Welfare, PO BOX 27, 00300, Helsinki, Finland.
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
BMC Endocr Disord. 2020 Mar 12;20(Suppl 1):140. doi: 10.1186/s12902-019-0468-y.
Feel4Diabetes was a school and community based intervention aiming to promote healthy lifestyle and tackle obesity for the prevention of type 2 diabetes among families in 6 European countries. We conducted this literature review in order to guide the development of evidence-based implementation of the Feel4Diabetes intervention. We focused on type 2 diabetes prevention strategies, including all the phases from risk identification to implementation and maintenance. Special focus was given to prevention among vulnerable groups and people under 45 years.
Scientific and grey literature published between January 2000 and January 2015 was searched for relevant studies using electronic databases. To present the literature review findings in a systematic way, we used the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. A complementary literature search from February 2015 to December 2018 was also conducted.
The initial review included 27 studies with a follow-up ≥12 months and 9 studies with a follow-up ≥6 months and with a participant mean age < 45 years. We found out that interventions should be targeted at people at risk to improve recruiting and intervention effectiveness. Screening questionnaires (primarily Finnish Diabetes Risk Score FINDRISC) and blood glucose measurement can both be used for screening; the method does not appear to affect intervention effectiveness. Screening and recruitment is time-consuming, especially when targeting lower socioeconomic status and age under 45 years. The intervention intensity is more important for effectiveness than the mode of delivery. Moderate changes in several lifestyle habits lead to good intervention results. A minimum of 3-year follow-up seemed to be required to show a reduction in diabetes risk in high-risk individuals. In participants < 45 years, the achieved results in outcomes were less pronounced. The complementary review included 12 studies, with similar results regarding intervention targets and delivery modes, as well as clinical significance.
This narrative review highlighted several important aspects that subsequently guided the development of the Feel4Diabetes high-risk intervention. Research on diabetes prevention interventions targeted at younger adults or vulnerable population groups is still relatively scarce. Feel4Diabetes is a good example of a project aiming to fill this research gap.
clinicaltrials.gov NCT02393872, registered 20th March 2015.
Feel4Diabetes 是一项基于学校和社区的干预措施，旨在促进健康的生活方式，预防 6 个欧洲国家的家庭患上 2 型糖尿病。我们进行了这项文献综述，以便为 Feel4Diabetes 干预措施的循证实施提供指导。我们专注于 2 型糖尿病预防策略，包括从风险识别到实施和维持的所有阶段。特别关注弱势群体和 45 岁以下人群的预防。
我们使用电子数据库搜索了 2000 年 1 月至 2015 年 1 月期间发表的科学和灰色文献，以寻找相关研究。为了系统地呈现文献综述结果，我们使用了 Reach、Effectiveness、Adoption、Implementation 和 Maintenance（RE-AIM）框架。我们还进行了 2015 年 2 月至 2018 年 12 月的补充文献搜索。
最初的综述包括 27 项随访时间超过 12 个月的研究和 9 项随访时间超过 6 个月且参与者平均年龄<45 岁的研究。我们发现，干预措施应该针对有风险的人群，以提高招募和干预效果。筛查问卷（主要是芬兰糖尿病风险评分 FINDRISC）和血糖测量都可用于筛查；该方法似乎不影响干预效果。筛查和招募很耗时，尤其是针对社会经济地位较低和年龄在 45 岁以下的人群。干预强度对效果比交付模式更重要。几个生活方式习惯的适度改变会带来良好的干预效果。在高危人群中，至少需要 3 年的随访才能显示出糖尿病风险的降低。在<45 岁的参与者中，结果的效果不太明显。补充审查包括 12 项研究，其干预目标和交付模式以及临床意义都相似。
这项叙述性综述强调了一些重要的方面，这些方面随后为 Feel4Diabetes 高危干预措施的制定提供了指导。针对年轻成年人或弱势群体的糖尿病预防干预研究仍然相对较少。Feel4Diabetes 是一个旨在填补这一研究空白的项目的一个很好的例子。
clinicaltrials.gov NCT02393872，注册于 2015 年 3 月 20 日。
