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Reducing the burden of non-insulin dependent diabetes mellitus by health education in a primary care setting

Objective

Objectives:

- to asses the efficacy of a special diet-exercise program in preventing or delaying the onset of NIDDM in individuals with impaired glucose tolerance (IGT) in a primary care setting in Europe t
- o study the risk factors for progression to diabetes in individuals with IGT
- to asses the effects of the life-style intervention on cardiovascular disease risk factors - to asses the effects of intervention on quality of life

Brief description:
Non-insulin-dependent diabetes mellitus (NIDDM) is an increasingly common disease with large impact on most European populations. NIDDM is characterized by the development complications which give rise to excessive rates of coronary heart disease, peripheral vascular disease, renal disease and visual impairment. Prevention of diabetes has become a major issue both scientifically and from a public health point of view due to the increased morbidity and mortality associated with the disease. The complications of NIDDM can best be postponed by postponing the onset of the disease.
The EDlPS study will enrol 900 individuals with impaired glucose tolerance (IGT, WHO criteria) for a 5- to 6-year-intervention period, with annual follow-ups, from 6 European countries. The intervention will be modified to the local conditions. The main issues are reaching and maintaining normal weight, low-fat and high-fiber diet and regular exercise. The 5-year-incidence of diabetes in this risk group is estimated to be 28 %. The power calculation is based on a 30% reduction in diabetes incidence due to a specific diet-exercise treatment. Anthropometric and metabolic parameters will be assessed annually. Also, a blood sample for genetic analysis will be drawn. Carefully designed questionnaires will be used to asses the medical history and quality of life of the individuals recruited in the study.
The proposed project on prevention of NIDDM would potentially bring solutions to the large medical and socio-economic burden associated with NIDDM. Furthermore this collaborative study will lead to a better understanding of the possibilities to prevent NIDDM and associated disorders, particularly cardiovascular complications in an out-patient, primary care setting.
Keywords:
Non-insulin-dependent diabetes mellitus, Prevention, Impaired glucose tolerance (IGT), Diet, Exercise, Treatment, Risk group, Primary prevention

Coordinator

NATIONAL PUBLIC HEALTH INSTITUTE
Address
166,Mannerheimintie 166
00300 Helsinki
Finland