A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial

P.W.A. Vermunt, I.E.J. Milder, F. Wielaard, J.H. de Vries, C.A. Baan, J.A.M. van Oers, G.P. Westert

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Aims 
To determine the effectiveness of a 2.5‐year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care.
Methods 
A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC‐score ≥ 13) in 14 general practices in the Netherlands. Intervention consisted of lifestyle counselling from the nurse practitioner and the general practitioner. Usual care consisted of oral and written information at the start of the study. Study groups were compared over 2.5 years regarding changes in clinical and lifestyle measures.
Results 
Both groups showed modest changes in body weight, glucose concentrations, physical activity and dietary intake [weight: intervention group, −0.8 (5.1) kg, usual care group, −0.4 (4.7) kg, (P = 0.69); fasting plasma glucose: intervention group, −0.17 (0.4) mmol/l, usual care group, −0.10 (0.5) mmol/l, (P = 0.10)]. Differences between groups were significant only for total physical activity and fibre intake. In the intervention group, self‐efficacy was significantly higher in individuals successful at losing weight compared with unsuccessful individuals. No significant differences in participant weight loss were found between general practitioners and nurse practitioners with different levels of motivation or self‐efficacy.
Conclusions 
Diabetes risk factors could significantly be reduced by lifestyle counselling in Dutch primary care. However, intervention effects above the effects attributable to usual care were modest. Higher participant self‐efficacy seemed to facilitate weight loss. Lack of motivation or self‐efficacy of professionals did not negatively influence participant guidance.
Original languageEnglish
Pages (from-to)223-231
JournalDiabetic Medicine: Journal of Diabetes UK
Volume29
Issue number8
DOIs
Publication statusPublished - 2012

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Type 2 Diabetes Mellitus
Nurse Practitioners
General Practice
General Practitioners
Exercise
Weights and Measures
Netherlands
Fasting

Cite this

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title = "A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial",
abstract = "Aims  To determine the effectiveness of a 2.5‐year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care.Methods  A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC‐score ≥ 13) in 14 general practices in the Netherlands. Intervention consisted of lifestyle counselling from the nurse practitioner and the general practitioner. Usual care consisted of oral and written information at the start of the study. Study groups were compared over 2.5 years regarding changes in clinical and lifestyle measures.Results  Both groups showed modest changes in body weight, glucose concentrations, physical activity and dietary intake [weight: intervention group, −0.8 (5.1) kg, usual care group, −0.4 (4.7) kg, (P = 0.69); fasting plasma glucose: intervention group, −0.17 (0.4) mmol/l, usual care group, −0.10 (0.5) mmol/l, (P = 0.10)]. Differences between groups were significant only for total physical activity and fibre intake. In the intervention group, self‐efficacy was significantly higher in individuals successful at losing weight compared with unsuccessful individuals. No significant differences in participant weight loss were found between general practitioners and nurse practitioners with different levels of motivation or self‐efficacy.Conclusions  Diabetes risk factors could significantly be reduced by lifestyle counselling in Dutch primary care. However, intervention effects above the effects attributable to usual care were modest. Higher participant self‐efficacy seemed to facilitate weight loss. Lack of motivation or self‐efficacy of professionals did not negatively influence participant guidance.",
author = "P.W.A. Vermunt and I.E.J. Milder and F. Wielaard and {de Vries}, J.H. and C.A. Baan and {van Oers}, J.A.M. and G.P. Westert",
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language = "English",
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pages = "223--231",
journal = "Diabetic Medicine: Journal of the British Diabetic Association",
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A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care : 2.5-year results of a randomized controlled trial. / Vermunt, P.W.A.; Milder, I.E.J.; Wielaard, F.; de Vries, J.H.; Baan, C.A.; van Oers, J.A.M.; Westert, G.P.

In: Diabetic Medicine: Journal of Diabetes UK, Vol. 29, No. 8, 2012, p. 223-231.

Research output: Contribution to journalArticleScientificpeer-review

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T1 - A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care

T2 - 2.5-year results of a randomized controlled trial

AU - Vermunt, P.W.A.

AU - Milder, I.E.J.

AU - Wielaard, F.

AU - de Vries, J.H.

AU - Baan, C.A.

AU - van Oers, J.A.M.

AU - Westert, G.P.

PY - 2012

Y1 - 2012

N2 - Aims  To determine the effectiveness of a 2.5‐year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care.Methods  A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC‐score ≥ 13) in 14 general practices in the Netherlands. Intervention consisted of lifestyle counselling from the nurse practitioner and the general practitioner. Usual care consisted of oral and written information at the start of the study. Study groups were compared over 2.5 years regarding changes in clinical and lifestyle measures.Results  Both groups showed modest changes in body weight, glucose concentrations, physical activity and dietary intake [weight: intervention group, −0.8 (5.1) kg, usual care group, −0.4 (4.7) kg, (P = 0.69); fasting plasma glucose: intervention group, −0.17 (0.4) mmol/l, usual care group, −0.10 (0.5) mmol/l, (P = 0.10)]. Differences between groups were significant only for total physical activity and fibre intake. In the intervention group, self‐efficacy was significantly higher in individuals successful at losing weight compared with unsuccessful individuals. No significant differences in participant weight loss were found between general practitioners and nurse practitioners with different levels of motivation or self‐efficacy.Conclusions  Diabetes risk factors could significantly be reduced by lifestyle counselling in Dutch primary care. However, intervention effects above the effects attributable to usual care were modest. Higher participant self‐efficacy seemed to facilitate weight loss. Lack of motivation or self‐efficacy of professionals did not negatively influence participant guidance.

AB - Aims  To determine the effectiveness of a 2.5‐year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care.Methods  A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC‐score ≥ 13) in 14 general practices in the Netherlands. Intervention consisted of lifestyle counselling from the nurse practitioner and the general practitioner. Usual care consisted of oral and written information at the start of the study. Study groups were compared over 2.5 years regarding changes in clinical and lifestyle measures.Results  Both groups showed modest changes in body weight, glucose concentrations, physical activity and dietary intake [weight: intervention group, −0.8 (5.1) kg, usual care group, −0.4 (4.7) kg, (P = 0.69); fasting plasma glucose: intervention group, −0.17 (0.4) mmol/l, usual care group, −0.10 (0.5) mmol/l, (P = 0.10)]. Differences between groups were significant only for total physical activity and fibre intake. In the intervention group, self‐efficacy was significantly higher in individuals successful at losing weight compared with unsuccessful individuals. No significant differences in participant weight loss were found between general practitioners and nurse practitioners with different levels of motivation or self‐efficacy.Conclusions  Diabetes risk factors could significantly be reduced by lifestyle counselling in Dutch primary care. However, intervention effects above the effects attributable to usual care were modest. Higher participant self‐efficacy seemed to facilitate weight loss. Lack of motivation or self‐efficacy of professionals did not negatively influence participant guidance.

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DO - 10.1111/j.1464-5491.2012.03648.x

M3 - Article

VL - 29

SP - 223

EP - 231

JO - Diabetic Medicine: Journal of the British Diabetic Association

JF - Diabetic Medicine: Journal of the British Diabetic Association

SN - 0742-3071

IS - 8

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