The incoming phase will be used for orientation about the experience gained in how to prevent type 2 Diabetes (T2D) by using life style changes (reduced weight gain, increased physical activity, less dietary fat, increased fibre intake) and also through genetic prediction. A long intervention program will be designed to start the implementation in Egypt during the re-integration phase with coordination with the implementing institutions. The curriculum of training the staff on different methodology from different specialities and Health Education material for Diabetic patients to change their life style will be prepared. Genetic prediction will be considered to identify individuals at risk of developing T2D. Some risk factors (elevated plasma glucose conc. in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle) are potentially reversible. Modifying these factors with a lifestyle-intervention program would prevent diabetes. In this program, middle-aged, overweight subjects are randomly assigned with impaired glucose tolerance to either the intervention group or the control group. Each subject in the intervention group receive individualized counselling aimed at reducing weight, total intake of fat, and intake of saturated fat and increasing intake of fibre and physical activity. The average age will be 50 years, and the mean body-mass index will be measured. An oral glucose-tolerance test will be performed annually; the diagnosis of diabetes is confirmed by a second test. The mean duration of follow-up is 2-3 years. The outcome of the incoming phase will be a Plan to implement Diabetes Prevention Program in Egypt with simplified curriculum and health education materials. In the re-integration period, there will be a start of implementation with workshop and training courses for the staff contributing in the project. A pilot study will be done during the 6 month which will include life style changes and genetic polymorphism study.
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