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  • Individuals at high risk for type 2 diabetes invited to a lifestyle program: characteristics of participants versus non-participants (the HUNT Study) and 24-month follow-up of participants (the VEND-RISK Study)

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Epidemiology/Health Services Research
Individuals at high risk for type 2 diabetes invited to a lifestyle program: characteristics of participants versus non-participants (the HUNT Study) and 24-month follow-up of participants (the VEND-RISK Study)
  1. Ingrid Sørdal Følling1,2,3,
  2. Bård Kulseng3,4,
  3. Kristian Midthjell5,
  4. Vegar Rangul1,5,
  5. Anne-S Helvik2,6,7
  1. 1 Department of Health Sciences and Nursing, Nord University, Levanger, Norway
  2. 2 Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
  3. 3 Centre for Obesity Research, Clinic of Surgery, St. Olavs University Hospital, Trondheim, Norway
  4. 4 Department of Cancer Research and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
  5. 5 Department of Community Health and General Practice, Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology, Trondheim, Norway
  6. 6 Norwegian National Advisory Unit for Aging and Health, Vestfold Health Trust, Tønsberg, Norway
  7. 7 St. Olavs University Hospital, Trondheim, Norway
  1. Correspondence to Ingrid Sørdal Følling; ingfoll{at}gmail.com

Abstract

Objective Prevention of type 2 diabetes mellitus is possible through lifestyle programs, but the effect depends on the program's content, resources, and setting. Lifestyle programs are often confronted with high rates of non-participation and attrition. This study invited individuals at high risk for type 2 diabetes to a lifestyle program in the Norwegian primary healthcare setting. The aims were to investigate possible differences in characteristics between participants and non-participants and to study the effect of the lifestyle program at 24-month follow-up for participants.

Research design and methods Individuals identified at high risk for type 2 diabetes during the third survey of the Nord-Trøndelag Health Study (HUNT3) from two municipalities (n=332) were invited to a lifestyle program (the VEND-RISK Study). A cross-sectional design was used to explore if the participants’ characteristics differed from non-participants. A non-randomized, single-arm, pre–post examination was used to examine the effect of the lifestyle program on participants’ characteristics at 24-month follow-up.

Results Of all individuals at high risk for type 2 diabetes invited to the lifestyle program, 86% (287/332) declined to participate. Non-participating women had fewer years of education (p<0.001), compared with participating women. For men, no differences were seen between non-participants and participants. Among all participants (n=45) at 24-month follow-up, none had developed type 2 diabetes, and HbA1c (p<0.001) had decreased significantly. There was a small reduction in mean body mass index from baseline to 24 months that was not statistically significant. For women, waist circumference (−4.0 cm, p<0.001) decreased significantly.

Conclusions Future research regarding individuals at high risk for type 2 diabetes in the primary healthcare lifestyle program should focus on how to promote recruitment of women with low education. Participants attending this study's lifestyle program improved their cardiometabolic markers.

Clinical trials registration NCT01135901; Results.

  • lifestyle programme
  • primary health care
  • type 2 diabetes
  • FINDRISC
  • non-participants

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000368

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    Footnotes

    • Contributors BK planned and was responsible for the VEND-RISK Study. KM conducted and organized the HUNT DE-PLAN Study. ISF, BK and A-SH designed the present study together with KM and VR. ISF analyzed the data and interpreted the results, together with A-SH and BK. ISF drafted the manuscript with comments from A-SH, BK and VR. All authors read the final manuscript.

    • Funding Nord University, Levanger, Norway, funded this research.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The Regional Committees for Medical and Health Research Ethics (REK), Norway (REK nr 2010/696) approved the study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The unpublished data from the current study are not publicly available due to secure the anonymity of the participants, but datasets are available from the corresponding author on reasonable request and with permission of The Regional Committee for Medical and Health Research Ethics in Central Norway. The Regional Committee for Medical and Health Research Ethics in Central Norway has not given access to datasets to others than the authors. Restrictions therefore apply to the availability of these data.