Implementation and effectiveness of the first community lifestyle intervention programme to prevent Type 2 diabetes in Greece. The DE-PLAN study.

ABSTRACT

AIMS: To report our experience of implementing the first community-based lifestyle intervention programme to detect high-risk individuals and prevent the development of Type 2 diabetes mellitus (T2DM) in a general population sample in Athens, Greece (the DE-PLAN Study). METHODS: The Finnish Type 2 Diabetes Risk Score (FINDRISC) questionnaire was distributed to 7900 people at workplaces and primary-care centres. High-risk individuals were invited to receive an oral glucose tolerance test (OGTT) and, after excluding persons with diabetes, to participate in a 1-year intervention programme, based on bimonthly sessions with a dietitian. RESULTS: Three thousand, two hundred and forty questionnaires were returned; 620 high-risk individuals were identified and 191 agreed to participate. Recruitment from workplaces was the most successful strategy for identifying high-risk persons, enrolling and maintaining them throughout the study. The 125 participants who fully completed the programme (66 did not return for a second OGTT) lost on average 1.0+/-4.7 kg (P=0.022). Higher adherence to the intervention sessions resulted in more significant weight loss (1.1+/-4.8 vs. 0.6+/-4.6 kg for low adherence). Persons with impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT) at baseline lost more weight than those with normal glucose tolerance (1.5+/-4.8 vs. -0.2+/-4.5 kg). The percentage of people with any type of dysglycaemia (IFG/IGT) was lower after the intervention (68.0% at baseline vs. 53.6% 1 year later, P=0.009); 5.6% developed diabetes. CONCLUSIONS: The implementation of a lifestyle intervention programme to prevent T2DM in the community is practical and feasible, accompanied by favourable lifestyle changes. Recruitment from workplaces was the most successful strategy.