scholarly journals Do statins interfere with lifestyle intervention in the prevention of diabetes in primary healthcare? One-year follow-up of the FIN-D2D project

BMJ Open ◽  
2012 ◽  
Vol 2 (5) ◽  
pp. e001472 ◽  
Author(s):  
Nina Rautio ◽  
Jari Jokelainen ◽  
Heikki Oksa ◽  
Timo Saaristo ◽  
Markku Peltonen ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Primary Healthcare ◽  
One Year ◽  
Prevention Of Diabetes

scholarly journals Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

2021 ◽  
Author(s):  
Andreas Fritsche ◽  
Robert Wagner ◽  
Martin Heni ◽  
Kostantinos Kantartzis ◽  
Jürgen Machann ◽  
...  
Keyword(s):  
High Risk ◽  
Lifestyle Intervention ◽  
Low Risk ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Randomized Controlled ◽  
The Difference ◽  
Prevention Of Diabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

scholarly journals Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

2021 ◽  
Author(s):  
Andreas Fritsche ◽  
Robert Wagner ◽  
Martin Heni ◽  
Kostantinos Kantartzis ◽  
Jürgen Machann ◽  
...  
Keyword(s):  
High Risk ◽  
Lifestyle Intervention ◽  
Low Risk ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Randomized Controlled ◽  
The Difference ◽  
Prevention Of Diabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

scholarly journals Different Effects of Lifestyle Intervention in High- and Low-Risk Prediabetes

2021 ◽  
Author(s):  
Andreas Fritsche ◽  
Robert Wagner ◽  
Martin Heni ◽  
Kostantinos Kantartzis ◽  
Jürgen Machann ◽  
...  
Keyword(s):  
High Risk ◽  
Lifestyle Intervention ◽  
Low Risk ◽  
Liver Fat ◽  
Liver Fat Content ◽  
Randomized Controlled ◽  
The Difference ◽  
Prevention Of Diabetes

Lifestyle intervention (LI) can prevent type 2 diabetes, but response to LI varies depending on risk subphenotypes. We tested if prediabetic individuals with low risk benefit from conventional LI and individuals with high risk benefit from an intensification of LI in a multi-center randomized controlled intervention over 12 months with 2 years follow up. 1105 prediabetic individuals based on ADA glucose criteria were stratified into a high- and low-risk phenotype, based on previously described thresholds of insulin secretion, insulin sensitivity and liver fat content. Low-risk individuals were randomly assigned to conventional LI according to the DPP protocol or control (1:1), high-risk individuals to conventional or intensified LI with doubling of required exercise (1:1). A total of 908 (82%) participants completed the study. In high-risk individuals, the difference between conventional and intensified LI in post-challenge glucose change was -0.29 mmol/l [CI:-0.54;-0.04], p=0.025. Liver fat (-1.34 percentage points [CI:-2.17;-0.50], p=0.002) and cardiovascular risk (-1.82[CI:-3.13-0.50],p=0.007) underwent larger reductions with intensified than with conventional LI. During a follow up of 3 years, intensified compared to conventional LI had a higher probability to normalize glucose tolerance (p=0.008). In conclusion, it is possible in high-risk individuals with prediabetes to improve glycemic and cardiometabolic outcomes by intensification of LI. Individualized, risk-phenotype-based LI may be beneficial for the prevention of diabetes.

scholarly journals Can the Onset of Type 2 Diabetes Be Delayed by a Group-Based Lifestyle Intervention in Women with Prediabetes following Gestational Diabetes Mellitus (GDM)? Findings from a Randomized Control Mixed Methods Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Angela O’Dea ◽  
Marie Tierney ◽  
Brian E. McGuire ◽  
John Newell ◽  
Liam G. Glynn ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Gestational Diabetes ◽  
Lifestyle Intervention ◽  
Intervention Group ◽  
Outcome Variable ◽  
Control Group ◽  
One Year

Objective. To evaluate a 12-week group-based lifestyle intervention programme for women with prediabetes following gestational diabetes (GDM).Design. A two-group, mixed methods randomized controlled trial in which 50 women with a history of GDM and abnormal glucose tolerance postpartum were randomly assigned to intervention (n=24) or wait control (n=26) and postintervention qualitative interviews with participants.Main Outcome Measures. Modifiable biochemical, anthropometric, behavioural, and psychosocial risk factors associated with the development of type 2 diabetes. The primary outcome variable was the change in fasting plasma glucose (FPG) from study entry to one-year follow-up.Results. At one-year follow-up, the intervention group showed significant improvements over the wait control group on stress, diet self-efficacy, and quality of life. There was no evidence of an effect of the intervention on measures of biochemistry or anthropometry; the effect on one health behaviour, diet adherence, was close to significance.Conclusions. Prevention programmes must tackle the barriers to participation faced by this population; home-based interventions should be investigated. Strategies for promoting long-term health self-management need to be developed and tested.

Abstract 186: Longer Term Effect of Lifestyle Intervention on Blood Pressure Control Among African Americans: One Year Follow-up of Shake, Rattle & Roll Trial

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Mai N Nguyen Huynh ◽  
Joseph D Young ◽  
Meghan Hatfield ◽  
Stacey Alexeeff ◽  
Terrence Chinn ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African Americans ◽  
Lifestyle Intervention ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Term Effect ◽  
One Year

Socioeconomic position and effectiveness of lifestyle intervention in prevention of type 2 diabetes: One-year follow-up of the FIN-D2D project

2011 ◽  
Vol 39 (6) ◽  
pp. 561-570 ◽  
Author(s):  
Nina Rautio ◽  
Jari Jokelainen ◽  
Heikki Oksa ◽  
Timo Saaristo ◽  
Markku Peltonen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Lifestyle Intervention ◽  
Socioeconomic Position ◽  
One Year

scholarly journals Healthcare Contacts Regarding Circulatory Conditions among Swedish Patients in Opioid Substitution Treatment, with and without On-Site Primary Healthcare

2021 ◽  
Vol 18 (9) ◽  
pp. 4614
Author(s):  
Eric Bäckström ◽  
Katja Troberg ◽  
Anders Håkansson ◽  
Disa Dahlman
Keyword(s):  
Primary Healthcare ◽  
Survey Study ◽  
Small Scale ◽  
Substitution Treatment ◽  
Opioid Substitution Treatment ◽  
Mortality And Morbidity ◽  
Healthcare Needs ◽  
One Year ◽  
Opioid Substitution

Patients in Opioid Substitution Treatment (OST) have increased mortality and morbidity, with circulatory conditions suggested to be a contributing factor. Since OST patients tend to have unmet physical healthcare needs, a small-scale intervention providing on-site primary healthcare (PHC) in OST clinics was implemented in Malmö, Sweden in 2016. In this study, we assessed registered circulatory conditions and healthcare utilization in OST patients with and without use of on-site PHC. Patients from four OST clinics in Malmö, Sweden, were recruited to a survey study in 2017–2018. Medical records for the participants were retrieved for one year prior to study participation (n = 192), and examined for circulatory diagnoses, examinations and follow-ups. Patients with and without on-site PHC were compared through descriptive statistics and univariate analyses. Eighteen percent (n = 34) of the sample had 1≤ registered circulatory condition, and 6% (n = 12) attended any clinical physiology examination or follow-up, respectively. Among patients utilizing on-site PHC (n = 26), the numbers were 27% (n = 7) for circulatory diagnosis, 15% (n = 4) for examinations, and 12% (n = 3) for follow-up. OST patients seem underdiagnosed in regard to their circulatory health. On-site PHC might be a way to diagnose and treat circulatory conditions among OST patients, although further research is needed.

scholarly journals A cost-utility analysis of multimodal pain rehabilitation in primary healthcare

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Katarina Eklund ◽  
Britt-Marie Stålnacke ◽  
Gunilla Stenberg ◽  
Paul Enthoven ◽  
Björn Gerdle ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cost Effectiveness ◽  
Primary Healthcare ◽  
Cost Savings ◽  
Cost Utility ◽  
Cost Utility Analysis ◽  
Utility Analysis ◽  
One Year ◽  
The Cost

AbstractObjectivesMultimodal rehabilitation programs (MMRPs) have been shown to be both cost-effective and an effective method for managing chronic pain in specialist care. However, while the vast majority of patients are treated in primary healthcare, MMRPs are rarely practiced in these settings. Limited time and resources for everyday activities alongside the complexity of chronic pain makes the management of chronic pain challenging in primary healthcare and the focus is on unimodal treatment. In order to increase the use of MMRPs incentives such as cost savings and improved health status in the patient group are needed. The aim of this study was to evaluate the cost-effectiveness of MMRPs for patients with chronic pain in primary healthcare in two Swedish regions. The aim of this study was to evaluate the cost-effectiveness of MMRPs at one-year follow-up in comparison with care as usual for patients with chronic pain in primary healthcare in two Swedish regions.MethodsA cost-utility analysis was performed alongside a prospective cohort study comparing the MMRP with the alternative of continuing with care as usual. The health-related quality of life (HRQoL), using EQ5D, and working situation of 234 participants were assessed at baseline and one-year follow-up. The primary outcome was cost per quality-adjusted life year (QALY) gained while the secondary outcome was sickness absence. An extrapolation of costs was performed based on previous long-term studies in order to evaluate the effects of the MMRP over a five-year time period.ResultsThe mean (SD) EQ5D index, which measures HRQoL, increased significantly (p<0.001) from 0.34 (0.32) to 0.44 (0.32) at one-year follow-up. Sickness absence decreased by 15%. The cost-utility analysis showed a cost per QALY gained of 18 704 € at one-year follow-up.ConclusionsThe results indicate that the MMRP significantly improves the HRQoL of the participants and is a cost-effective treatment for patients with chronic pain in primary healthcare when a newly suggested cost-effectiveness threshold of 19 734 € is implemented. The extrapolation indicates that considerable cost savings in terms of reduced loss of production and gained QALYs may be generated if the effects of the MMRP are maintained beyond one-year follow-up. The study demonstrates potential benefits of MMRPs in primary healthcare for both the patient with chronic pain and the society as a whole. The cost-effectiveness of MMRPs in primary healthcare has scarcely been studied and further long-term studies are needed in these settings.

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