ACHIEVING BEST PRACTICE

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 ALEKSANDRA GILIS-JANUSZEWSKA1, ZBIGNIEW SZYBINSKI1, KATARZYNA KISSIMOVA-SKARBEK2, BEATA PIWONSKA-SOLSKA1, DOROTA PACH1, ROMAN TOPOR-MADRY2, JAAKKO TUOMILEHTO3,4,5,6 JAANA LINDSTRÖM3, MARKKU PELTONEN7, PETER EH SCHWARZ8, ALICJA HUBALEWSKA-DYDEJCZYK1 Abstract Aim To find out whether diabetes prevention via a lifestyle intervention programme is feasible in a primary healthcare setting in Poland. Methods The intervention (Diabetes in Europe: Prevention using Lifestyle, physical Activity and Nutritional intervention; DE-PLAN project) was completed by 175 middle-aged, slightly obese participants in nine primary healthcare centres in Krakow, Poland. The inclusion criterion was diabetes risk (Finnish Diabetes Risk score (FRS) >14). The nurse-delivered intervention consisted of 10 group

1

Department of Endocrinology, Collegium Medicum, Jagiellonian University, Krakow, Poland. 2 Institute of Public Health, Collegium Medicum, Jagiellonian University, Krakow, Poland. 3 University of Helsinki, Department of Public Health, Hjelt Institute, Helsinki, Finland. 4 South Ostrobothnia Central Hospital, Seinäjoki, Finland 5 Department of Clinical and Preventive Medicine, Danube-University Krems, Krems, Austria 6 Red RECAVA Grupo RD06/0014/0015, Hospital Universitario La Paz, Madrid, Spain 7 National Institute for Health and Welfare, Diabetes Prevention Unit, Helsinki, Finland 8 Medical Faculty Carl Gustav Carus of the Technical University Dresden, Department of Medicine III, Dresden, Germany. Correspondence to: Dr. Aleksandra Gilis-Januszewska Jagiellonian University, Medical College, Dep. of Endocrinology Kopernika Street 17, 31 501 Krakow, Poland Tel: +48 (0)505 164 348; Fax: +48 (0)12 424 73 99 E-mail [email protected]

Abbreviations and acronyms DE-PLAN Diabetes in Europe: Prevention using Lifestyle, physical Activity and Nutritional intervention DPS Finnish Diabetes Prevention Study DPP Diabetes Prevention Program BMI body mass index CVD cardiovascular disease FINDRISC Finnish Diabetes Risk FRS FINDRISC score GGT Greater Green Triangle GOAL Good Ageing in Lahti Region HDL high-density lipoprotein IDPP Indian Diabetes Prevention Study IFG impaired fasting glucose IGT impaired glucose tolerance OGTT oral glucose tolerance test PREDIAS Prevention of Diabetes Self-Management Program TG triglycerides

sessions on lifestyle changes, six motivational telephone sessions, two motivational letters and the opportunity to participate in once or twice weekly physical activity sessions. Results At 12 months there were mean reductions in weight, 85.7 to 83.7 kg; body mass index, 31.8 to 31.1 kg/m2 (p