#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The effectiveness of a community-based, type 2 diabetes prevention programme on health-related quality of life. The DE-PLAN study


Autoři: Georgios Karamanakos aff001;  Bernardo Costa-Pinel aff002;  Aleksandra Gilis-Januszewska aff003;  Dzilda Velickiene aff004;  Francisco Barrio-Torrell aff002;  Xavier Cos-Claramunt aff002;  Santiago Mestre-Miravet aff002;  Beata Piwońska-Solska aff003;  Alicja Hubalewska-Dydejczyk aff003;  Jaakko Tuomilehto aff005;  Stavros Liatis aff001;  Konstantinos Makrilakis aff001
Působiště autorů: First Department of Propaedeutic Medicine, Diabetes Center, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece aff001;  Catalan Diabetes Prevention Research Group, Jordi Gol Primary Care Research Institute, Catalan Health Institute, Primary Health Care Division, Reus-Barcelona, Spain aff002;  Department of Endocrinology, Jagiellonian University, Medical College, Krakow, Poland aff003;  Lithuanian University of Health Sciences, Institute of Endocrinology, Kaunas, Lithuania, LT aff004;  Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland aff005;  Department of Public Health, University of Helsinki, Helsinki, Finland aff006;  Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia aff007
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0221467

Souhrn

Background and aims

The DE-PLAN was a European multicenter study, with the primary objective of testing whether a community-based lifestyle modification programme could serve as a means of primary prevention for type 2 diabetes (T2D) in high-risk individuals (based on the FINDRISC questionnaire). The aim of this study was to examine the impact of a 1-year community-based lifestyle intervention on health-related quality of life (HRQOL) in individuals from four participating European centers (Athens, Barcelona, Krakow, Kaunas), through a post-hoc analysis.

Materials and methods

Each center was allowed to implement different intervention strategies specifically tailored to the needs of their corresponding population sample. Before and after the intervention, participants underwent clinical evaluation, anthropometric measurements, an oral glucose tolerance test and lipid profile measurements. Health-related quality of life was assessed using the validated HRQOL-15D questionnaire. A difference of ±0.015 in the 15D questionnaire score was set as the threshold of clinically meaningful change.

Results

Data from 786 participants (67% females, mean age 59.7±9.4 years, BMI 31.5±4.5 kg/m2) with complete data regarding the HRQOL were analyzed (Athens: 104, Barcelona: 434, Krakow: 175, Kaunas: 70). After 1 year, a significant overall improvement in HRQOL was shown, as depicted by a change of 15D score from baseline value (0.88±0.9) to post-intervention (0.90±0.87, P<0.001), achieving the threshold of clinically meaningful change. A significant weight reduction was also observed (-0.8±4.0 kg, P<0.001). In multivariate analysis, improvement in HRQOL was independently associated with lower 15D score at baseline (P<0.001) and self-reported increase in overall exercise time (P<0.001) as assessed through specifically designed trial questionnaires.

Conclusion

A community-based lifestyle intervention programme aiming at T2D prevention, applied on a heterogeneous population and with varied methods, was shown to improve overall health-related quality of life to a clinically meaningful degree.

Klíčová slova:

Community based intervention – Physical activity – Quality of life – Questionnaires – Weight loss – Diabetes prevention


Zdroje

1. Tuomilehto J, Lindström J, Eriksson JG, Valle TT, Hämäläinen H, Ilanne-Parikka P, et al. Prevention of Type 2 Diabetes Mellitus by Changes in Lifestyle among Subjects with Impaired Glucose Tolerance. New England Journal of Medicine. 2001;344: 1343–1350. doi: 10.1056/NEJM200105033441801 11333990

2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346: 393–403. doi: 10.1056/NEJMoa012512 11832527

3. Dunkley AJ, Bodicoat DH, Greaves CJ, Russell C, Yates T, Davies MJ, et al. Diabetes prevention in the real world: Effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations—A systematic review and meta-analysis. Diabetes Care. 2014. pp. 922–933. doi: 10.2337/dc13-2195 24652723

4. Kahn R, Davidson MB. The reality of type 2 diabetes prevention. Diabetes Care. 2014. pp. 943–949. doi: 10.2337/dc13-1954 24652724

5. Schwarz PEH, Lindström J, Kissimova-Scarbeck K, Szybinski Z, Barengo NC, Peltonen M, et al. The European perspective of type 2 diabetes prevention: Diabetes in Europe—Prevention using lifestyle, physical activity and nutritional intervention (DE-PLAN) project. Experimental and Clinical Endocrinology and Diabetes. 2008;116: 167–172. doi: 10.1055/s-2007-992115 18350480

6. Sikdar KC, Wang PP, MacDonald D, Gadag VG. Diabetes and its impact on health-related quality of life: a life table analysis. Quality of life research: an international journal of quality of life aspects of treatment, care and rehabilitation. 2010;19: 781–7. doi: 10.1007/s11136-010-9641-5 20349211

7. Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Diez Roux A V., et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA—Journal of the American Medical Association. 2008; doi: 10.1001/jama.299.23.2751 18560002

8. Holt RIG, de Groot M, Golden SH. Diabetes and Depression. Current Diabetes Reports. 2014;14: 491. doi: 10.1007/s11892-014-0491-3 24743941

9. Holt RIG, Katon WJ. Dialogue on Diabetes and Depression: Dealing with the double burden of co-morbidity. Journal of affective disorders. 2012;142 Suppl: S1–3. doi: 10.1016/S0165-0327(12)00632-5

10. Burroughs TE, Desikan R, Waterman BM, Gilin D, McGill J. Development and Validation of the Diabetes Quality of Life Brief Clinical Inventory. Diabetes Spectrum. 2004;17: 41–49. doi: 10.2337/diaspect.17.1.41

11. Chittleborough CR, Baldock KL, Taylor AW, Phillips PJ. Health Status Assessed by the SF-36 Along the Diabetes Continuum in an Australian Population. Quality of Life Research. 2006;15: 687–694. doi: 10.1007/s11136-005-3570-8 16688501

12. Seppälä T, Saxen U, Kautiainen H, Järvenpää S, Korhonen PE. Impaired glucose metabolism and health related quality of life. Primary Care Diabetes. 2013;7: 223–227. doi: 10.1016/j.pcd.2013.03.001 23639608

13. Hunger M, Holle R, Meisinger C, Rathmann W, Peters A, Schunk M. Longitudinal changes in health-related quality of life in normal glucose tolerance, prediabetes and type 2 diabetes: results from the KORA S4/F4 cohort study. Quality of Life Research. 2014;23: 2515–2520. doi: 10.1007/s11136-014-0689-5 24729056

14. Neumann A, Schoffer O, Norström F, Norberg M, Klug SJ, Lindholm L. Health-related quality of life for pre-diabetic states and type 2 diabetes mellitus: a cross-sectional study in Västerbotten Sweden. Health and quality of life outcomes. 2014;12: 150. doi: 10.1186/s12955-014-0150-z 25342083

15. Lindström J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes care. 2003;26: 725–31. Available: http://www.ncbi.nlm.nih.gov/pubmed/12610029 doi: 10.2337/diacare.26.3.725 12610029

16. World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Journal of American Medical Association. 2013;310: 2191–2194. doi: 10.1001/jama.2013.281053 24141714

17. Makrilakis K, Liatis S, Grammatikou S, Perrea D, Katsilambros N. Implementation and effectiveness of the first community lifestyle intervention programme to prevent Type 2 diabetes in Greece. the DE-PLAN study. Diabetic Medicine. 2010;27: 459–465. doi: 10.1111/j.1464-5491.2010.02918.x 20536519

18. Costa B, Barrio F, Cabré J-J, Piñol J-L, Cos X, Solé C, et al. Delaying progression to type 2 diabetes among high-risk Spanish individuals is feasible in real-life primary healthcare settings using intensive lifestyle intervention. Diabetologia. 2012;55: 1319–28. doi: 10.1007/s00125-012-2492-6 22322921

19. Gilis-Januszewska A, Szybinski Z, Kissimova-Skarbek K, Piwonska-Solska B, Pach D, Topor-Madry R, et al. Prevention of type 2 diabetes by lifestyle intervention in primary health care setting in Poland: Diabetes in Europe Prevention using Lifestyle, physical Activity and Nutritional intervention (DE-PLAN) project. The British Journal of Diabetes & Vascular Disease. 2011;11: 198–203. doi: 10.1177/1474651411412429

20. Telle-Hjellset V, Kjollesdal MKR, Bjorge B, Holmboe-Ottesen G, Wandel M, Birkeland KI, et al. The InnvaDiab-DE-PLAN study: A randomised controlled trial with a culturally adapted education programme improved the risk profile for type 2 diabetes in Pakistani immigrant women. British Journal of Nutrition. 2013;109: 529–538. doi: 10.1017/S000711451200133X 22717286

21. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical chemistry. 1972;18: 499–502. Available: http://www.ncbi.nlm.nih.gov/pubmed/4337382 4337382

22. WHO. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia. Who2. 2006; 50. doi:ISBN 92 4 159493 4

23. Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Annals of medicine. 2001;33: 328–336. doi: 10.3109/07853890109002086 11491191

24. Hawthorne G, Richardson J, Day NA. A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments. Annals of Medicine. 2001;33: 358–370. doi: 10.3109/07853890109002090 11491195

25. Alanne S, Roine RP, Räsänen P, Vainiola T, Sintonen H. Estimating the minimum important change in the 15D scores. Quality of Life Research. 2015;24: 599–606. doi: 10.1007/s11136-014-0787-4 25145637

26. Lindstrom J, Louheranta a., Mannelin M, Rastas M, Salminen V, Eriksson J, et al. The Finnish Diabetes Prevention Study (DPS). Diabetes Care. 2003;26: 3230–3236. doi: 10.2337/diacare.26.12.3230 14633807

27. Makrilakis K, Liatis S, Grammatikou S, Perrea D, Stathi C, Tsiligros P, et al. Validation of the Finnish diabetes risk score (FINDRISC) questionnaire for screening for undiagnosed type 2 diabetes, dysglycaemia and the metabolic syndrome in Greece. Diabetes & metabolism. 2011;37: 144–151.

28. Schroder H, Fito M, Estruch R, Martinez-Gonzalez MA, Corella D, Salas-Salvado J, et al. A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women. Journal of Nutrition. 2011;141: 1140–1145. doi: 10.3945/jn.110.135566 21508208

29. Costa-Pinel B, Mestre-Miravet S, Barrio-Torrell F, Cabré-Vila J-J, Cos-Claramunt X, Aguilar-Sanz S, et al. Implementation of the DP-TRANSFERS project in Catalonia: A translational method to improve diabetes screening and prevention in primary care. PLOS ONE. Public Library of Science; 2018;13: e0194005.

30. Gilis-Januszewska A, Lindström J, Tuomilehto J, Piwońska-Solska B, Topór-Mądry R, Szybiński Z, et al. Sustained diabetes risk reduction after real life and primary health care setting implementation of the diabetes in Europe prevention using lifestyle, physical activity and nutritional intervention (DE-PLAN) project. BMC Public Health. 2017;17. doi: 10.1186/s12889-017-4104-3 28202029

31. Gilis-Januszewska A, Piwońska-Solska B, Lindström J, Wójtowicz E, Tuomilehto J, Schwarz PEH, et al. Determinants of weight outcomes in type 2 diabetes prevention intervention in primary health care setting (the DE-PLAN project). BMC Public Health. 2018;18: 97. doi: 10.1186/s12889-017-4977-1 29291708

32. Gilis-Januszewska A, Lindström J, Barengo NC, Tuomilehto J, Schwarz PE, Wójtowicz E, et al. Predictors of completing a primary health care diabetes prevention intervention programme in people at high risk of type 2 diabetes: Experiences of the DE-PLAN project. Medicine. 2018; doi: 10.1097/MD.0000000000009790 29384876

33. Florez H, Pan Q, Ackermann RT, Marrero DG, Barrett-Connor E, Delahanty L, et al. Impact of Lifestyle Intervention and Metformin on Health-Related Quality of Life: the Diabetes Prevention Program Randomized Trial. Journal of General Internal Medicine. 2012; 1–8. doi: 10.1007/s11606-011-1923-2

34. Ibrahim N, Moy FM, Awalludin IAN, Ali ZM, Ismail IS. Effects of a community-based healthy lifestyle intervention program (Co-HELP) among adults with prediabetes in a developing country: A quasi-experimental study. PLoS ONE. 2016;11. doi: 10.1371/journal.pone.0167123 27935988

35. Kilkkinen A, Heistaro S, Laatikainen T, Janus E, Chapman A, Absetz P, et al. Prevention of type 2 diabetes in a primary health care setting. Interim results from the Greater Green Triangle (GGT) Diabetes Prevention Project. Diabetes Research and Clinical Practice. 2007;76: 460–462. doi: 10.1016/j.diabres.2006.09.027 17069921

36. Williamson DA, Rejeski J, Lang W, Van Dorsten B, Fabricatore AN, Toledo K. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes. Archives of Internal Medicine. 2009;169: 163–171. doi: 10.1001/archinternmed.2008.544 19171813

37. Engel SG, Crosby RD, Kolotkin RL, Hartley GG, Williams GR, Wonderlich SA, et al. Impact of weight loss and regain on quality of life: Mirror image or differential effect? Obesity Research. 2003;11: 1207–1213. doi: 10.1038/oby.2003.166 14569046

38. Savolainen J, Miettola J, Kautiainen H, Mäntyselkä P, Niskanen L. Low quality of life and depressive symptoms are connected with an unhealthy lifestyle. Scandinavian Journal of Public Health. 2014;42: 163–170. doi: 10.1177/1403494813504837 24048729

39. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379: 2279–90. doi: 10.1016/S0140-6736(12)60283-9 22683128

40. Bize R, Johnson JA, Plotnikoff RC. Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine. 2007. pp. 401–415. doi: 10.1016/j.ypmed.2007.07.017 17707498

41. Maciejewski ML, Patrick DL, Williamson DF. A structured review of randomized controlled trials of weight loss showed little improvement in health-related quality of life. Journal of Clinical Epidemiology. 2005;58: 568–578. doi: 10.1016/j.jclinepi.2004.10.015 15878470

42. Hayes AJ, Clarke PM, Glasziou PG, Simes RJ, Drury PL, Keech AC. Can self-rated health scores be used for risk prediction in patients with type 2 diabetes? Diabetes Care. 2008;31: 795–797. doi: 10.2337/dc07-1391 18184900

43. The FIELD Study Investigators. The need for a large-scale trial of fibrate therapy in diabetes: the rationale and design of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. [ISRCTN64783481]. Cardiovascular Diabetology. 2004;3: 9. doi: 10.1186/1475-2840-3-9 15571637

44. Wennberg P, Rolandsson O, Jerdén L, Boeing H, Sluik D, Kaaks R, et al. Self-rated health and mortality in individuals with diabetes mellitus: Prospective cohort study. BMJ Open. 2012;2: e000760. doi: 10.1136/bmjopen-2011-000760 22337818

45. Makrilakis K, Liatis S, Tsiakou A, Stathi C, Papachristoforou E, Perrea D, et al. Comparison of health-related quality of Life (HRQOL) among patients with pre-diabetes, diabetes and normal glucose tolerance, using the 15D-HRQOL questionnaire in Greece: the DEPLAN study. BMC Endocrine Disorders. 2018;18: 32. doi: 10.1186/s12902-018-0261-3 29843700

46. Väätäinen S, Cederberg H, Roine R, Keinänen-Kiukaanniemi S, Saramies J, Uusitalo H, et al. Does future diabetes risk impair current quality of life? A cross-sectional study of health-related quality of life in relation to the Finnish diabetes risk score (FINDRISC). PLoS ONE. 2016;11. doi: 10.1371/journal.pone.0147898 26840374

47. Heydari I, Radi V, Razmjou S, Amiri A. Chronic complications of diabetes mellitus in newly diagnosed patients. International Journal of Diabetes Mellitus. 2010;2: 61–63. doi: 10.1016/j.ijdm.2009.08.001

48. Bansal D, Gudala K, Esam HP, Nayakallu R, Vyamusani RV, Bhansali A. Microvascular Complications and Their Associated Risk Factors in Newly Diagnosed Type 2 Diabetes Mellitus Patients. International Journal of Chronic Diseases. 2014;2014: 1–7. doi: 10.1155/2014/201423 26464850

49. Qiao Q. Is the current definition for diabetes relevant to mortality risk from all causes and cardiovascular and noncardiovascular diseases? Diabetes Care. 2003;26: 688–696. doi: 10.2337/diacare.26.3.688 12610023

50. Zhou XH, Qiao Q, Zethelius B, Pyörälä K, Söderberg S, Pajak A, et al. Diabetes, prediabetes and cancer mortality. Diabetologia. 2010;53: 1867–1876. doi: 10.1007/s00125-010-1796-7 20490448

51. Barr ELM, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance: The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation. 2007;116: 151–157. doi: 10.1161/CIRCULATIONAHA.106.685628 17576864

52. Landman GWD, van Hateren KJJ, Kleefstra N, Groenier KH, Gans ROB, Bilo HJG. Health-related quality of life and mortality in a general and elderly population of patients with type 2 diabetes (ZODIAC-18). Diabetes care. 2010;33: 2378–82. doi: 10.2337/dc10-0979 20805257

53. Wing RR. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obesity Research. 2004;12: 1426–1434. doi: 10.1038/oby.2004.179 15483207

54. Lindström J, Peltonen M, Eriksson JG, Aunola S, Hämäläinen H, Ilanne-Parikka P, et al. Determinants for the effectiveness of lifestyle intervention in the finnish diabetes prevention study. Diabetes Care. 2008;31: 857–862. doi: 10.2337/dc07-2162 18252900


Článek vyšel v časopise

PLOS One


2019 Číslo 10
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

plice
INSIGHTS from European Respiratory Congress
nový kurz

Současné pohledy na riziko v parodontologii
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií
Autoři: prof. MUDr. Petr Němec, Ph.D.

Střevní příprava před kolonoskopií
Autoři: MUDr. Klára Kmochová, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#