To assess the long-term effectiveness of a pragmatic public healthcare strategy to prevent type 2 diabetes within primary care setting. In the extended follow-up of the DEPLANCAT project, we explored whether the originally-achieved risk reduction remains after discontinuation of active lifestyle intervention. Middle-aged men (n=184) and women (n=368) with Finnish Diabetes Risk Score (FINDRISC)>14 and/or prediabetes (WHO rules for fasting or 2-h glucose) were allocated not randomly but sequentially to standard care control (CG) or intensive lifestyle intervention (IG) group. After a median of 4.2 y of active intervention, participants who were still free of diabetes were further followed-up without any additional specific intervention for a median of 5.8 y (median total follow-up of 10.01 y) via computerized health-care records or direct personal contact with invitation to 2h-glucose retest. The primary outcome was the development of diabetes. During the active intervention, diabetes was diagnosed in 124 participants (22.5%): 63 (28.8%) in the CG and 61 (18.3%) in the IG. After 10 y, 27 people (4.9%) had died. Among the remaining 401 individuals, 34 diabetes diagnoses were traced using the health-care records. Additionally, among the 191 people (47.6%) who agreed to blood re-test (66 in the CG and 125 in the IG) 16 new cases were found. During the post-intervention follow-up the total number of new cases of diabetes was 16 in the CG and 34 in the IG. The absolute incidences of diabetes during the overall follow-up were 6.1 (95% CI 5.2-6.9) and 5.1 (4.4-5.8) per 100 person-years, respectively (p=0.019 log-rank). The corresponding HR was 0.59 (0.43-0.81) with a relative risk reduction of 16.6%. The NNT to prevent one case of diabetes was 10. Intensive lifestyle intervention in a primary care setting substantially reduces diabetes incidence among high-risk individuals. Risk reduction can persist for at least 10 years.


F. Barrio: None. B. Costa: None. F. Cos: None. J. Cabre: None. A. Martinez: None. S. Mestre: None. C. Castell: None. J. Lindstrom: None.


Institute of Health Carlos III, Spanish Ministry of Health and the European Regional Development Fund (PI14/00122, PI14/00124); La Marató de TV3 Foundation (73-201609.10); Spanish Diabetes Society; Department of Health, Generalitat de Catalunya; Pla Estratègic de Recerca i Innovació en Salut (SLT002/16/00045, SLT002/16/00154, SLT002/16/00093)

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