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加泰罗尼亚 DP-TRANSFERS 项目实施结果:改善初级保健中糖尿病筛查和预防的转化方法。

Results of the implementation of the DP-TRANSFERS project in Catalonia: a translational method to improve diabetes screening and prevention in primary care.

机构信息

Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus, Barcelona, Spain; CAP Sant Pere de Reus, Institut Català de la Salut, División de Atención Primaria. Reus, Tarragona, Spain.

Instituto de Investigación en Atención Primaria IDIAP Jordi Gol, Institut Català de la Salut, División de Atención Primaria, Reus, Barcelona, Spain; CAP Sant Pere de Reus, Institut Català de la Salut, División de Atención Primaria. Reus, Tarragona, Spain.

出版信息

Rev Clin Esp (Barc). 2024 Nov;224(9):569-579. doi: 10.1016/j.rceng.2024.08.003. Epub 2024 Aug 30.

Abstract

INTRODUCTION

DP-TRANSFERS is a translational lifestyle intervention project, which follows a previous protocol described in the DE-PLAN-CAT study.

OBJECTIVE

Analyze the feasibility of reproducing the intensive intervention and estimating the effect of translation in real conditions of clinical practice in primary care.

METHODOLOGY

Implementation of the face-to-face group intervention adjusted to 2 years. After screening, the intervention consisted of a basic module and a continuity module. Stratifying by clusters (health centers), a representative sample (centers, professionals and participants) was evaluated (FINDRISC > 11 and/or prediabetes) from 2016 to 2020. The effect of the intervention on the incidence of diabetes was analyzed.

RESULTS

The intervention, feasible in 95 of 123 centers, involved 343 of 647 professionals. Of 2381 subjects screened, 1713 participated in the basic module, with 1186 participants completing the first year and 776 completing the second. 121 participants (7.06%) were diagnosed with diabetes: 77 (4.49%) during the first year; 44 (2.57%) during the second. The bivariate analysis showed that those subjects in whom diabetes affected differed in: previous glycemic status, A1c, HDL-cholesterol, FINDRISC score and adherence to the Mediterranean diet, and in the differences between the beginning and end of the study of: body weight, BMI and abdominal circumference.

CONCLUSIONS

The intensive intervention substantially reduced (23.6%) the incidence of diabetes compared to that previously estimated in standardized intervention. The following acted as protective factors: a better glycemic status, lower baseline risk, elevated HDL-cholesterol, or achieving a reduction in weight or abdominal circumference during the study.

摘要

简介

DP-TRANSFERS 是一项转化生活方式的干预项目,它遵循了之前在 DE-PLAN-CAT 研究中描述的方案。

目的

分析在初级保健的临床实践中复制强化干预并估计翻译效果的可行性。

方法

实施面对面的小组干预,调整为 2 年。经过筛选,干预包括基础模块和连续性模块。按聚类(健康中心)分层,从 2016 年到 2020 年,评估有代表性的样本(中心、专业人员和参与者)(FINDRISC>11 和/或糖尿病前期)。分析干预对糖尿病发病率的影响。

结果

该干预在 123 个中心中的 95 个中心中是可行的,涉及 647 名专业人员中的 343 名。在筛选的 2381 名受试者中,1713 名参加了基础模块,其中 1186 名完成了第一年,776 名完成了第二年。121 名受试者(7.06%)被诊断患有糖尿病:77 名(4.49%)在第一年;44 名(2.57%)在第二年。单变量分析显示,患有糖尿病的受试者在以下方面存在差异:先前的血糖状况、A1c、高密度脂蛋白胆固醇、FINDRISC 评分和地中海饮食的依从性,以及研究开始和结束之间的差异:体重、BMI 和腰围。

结论

与之前标准化干预估计的发病率相比,强化干预大大降低了(23.6%)糖尿病的发病率。以下因素是保护因素:血糖状况更好、基线风险较低、HDL-胆固醇升高、或在研究期间体重或腰围减少。

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