Perceiving need for lifestyle counseling: findings from Finnish individuals at high risk of type 2 diabetes.

OBJECTIVE: To investigate the proportion of individuals at high risk of type 2 diabetes who perceive the need for lifestyle counseling, factors associated with this perception, and whether the perceived need is associated with subsequent attendance in lifestyle intervention. RESEARCH DESIGN AND METHODS: Baseline and intervention data were obtained from 10,149 participants in a Finnish National Diabetes Prevention Project. RESULTS: In total, 36% of men and 52% of women perceived the need for counseling. Most of the risk factors did not increase the perceived need for counseling. Those agreeing to attend supervised lifestyle intervention were more likely to report a perceived need than those who agreed on a self-initiated lifestyle change or those who refused to attend lifestyle intervention. The perceived need was associated with actual attendance in the lifestyle intervention only among women. CONCLUSIONS: It will be vital to find additional means to support lifestyle change.

Socio-economic differences in dysglycemia and lifestyle-related risk factors in the Finnish middle-aged population.

BACKGROUND: The aim of this study was to investigate the association of socio-economic status (SES) with dysglycemia and the lifestyle-related risk factors, and to analyze to which extent known risk factors explain socio-economic differences in diabetes risk. METHODS: Two population-based cross-sectional surveys in Finland including 1696 men and 1946 women aged 45-64 years who participated in a health examination in 2004 or 2007. Dysglycemia was determined by an oral glucose tolerance test. Total type 2 diabetes (including previously known and screen-detected type 2 diabetes), impaired glucose tolerance and impaired fasting glucose formed the category of total dysglycemia. Questionnaires and clinical examination were completed to assess risk factors for dysglycemia. SES was defined by education and household income. RESULTS: In both genders, the prevalence of total dysglycemia differed statistically significantly between educational groups. Low education was statistically significantly associated with higher risk of total type 2 diabetes in women. The household income level was inversely associated with total type 2 diabetes in women and with total dysglycemia in men. Obesity, unhealthy diet and smoking were all inversely related to SES in both men and women. The observed association between education and dysglycemia was slightly attenuated after adjustment for obesity and other risk factors for diabetes. CONCLUSIONS: Low education was associated with an increased risk of dysglycemia more strongly than the low household income. Risk factors, especially obesity, explained only partly the observed associations between dysglycemia and education.

High prevalence of obesity, central obesity and abnormal glucose tolerance in the middle-aged Finnish population.

BACKGROUND: There is a worldwide increase in the prevalence of obesity and disturbances in glucose metabolism. The aim of this study was to assess the current prevalence of obesity, central obesity and abnormal glucose tolerance in Finnish population, and to investigate the associations between body mass index (BMI), waist circumference and abnormal glucose tolerance. METHODS: A cross-sectional population-based survey was conducted in Finland during October 2004 and January 2005. A total of 4500 randomly selected individuals aged 45-74 years were invited to a health examination that included an oral glucose tolerance test. The participation rate was 62% in men and 67% in women. RESULTS: The prevalence of obesity was 23.5% (95% Confidence Interval (CI) 21.1-25.9) in men, and 28.0% (95% CI 25.5-30.5) in women. The overall prevalence of abnormal glucose tolerance (including type 2 diabetes, impaired glucose tolerance, or impaired fasting glucose) was 42.0% (95% CI 39.2-44.8) in men and 33.4% (95% CI 30.9-36.0) in women. The prevalence of previously unknown, screen-detected type 2 diabetes was 9.3% (95% CI 7.7-11.0) in men and 7.3% (95% CI 5.9-8.7) in women. Central obesity was associated with abnormal glucose tolerance within each of the three BMI categories normal (< 25 kg/m2), overweight (25-29 kg/m2), and obese (>or= 30 kg/m2). CONCLUSION: In a population-based random sample of Finnish population, prevalences of obesity, central obesity and abnormal glucose tolerance were found to be high. A remarkably high number of previously undetected cases of type 2 diabetes was detected. Waist circumference is a predictor of abnormal glucose tolerance in all categories of obesity.