BACKGROUND & AIMS:
BACKGROUND:The prevalence of type 2 diabetes has been increasing in Finland, in parallel with a gradual increase in overweight and obesity during the past decades. The expanding prevalence of type 2 diabetes brings along complications, most importantly CVD. Therefore, it is extremely important to implement activities to prevent type 2 diabetes.
OBJECTIVE:In the present paper, the clinical evidence for the prevention of type 2 diabetes is presented with the Finnish diabetes prevention study. In addition, the paper discusses the practical implementation of prevention of type 2 diabetes using three different types of prevention programmes as examples: FIN-D2D, including risk-screening and repeated consultation in primary health-care; FINNAIR, a workplace-targeted intervention project involving airline employees; and the good ageing in Lahti region (GOAL) programme, a community-based prevention programme.
CONCLUSIONS:FIN-D2D, the FINNAIR project and the GOAL programme have shown that screening for type 2 diabetes risk and implementing large-scale lifestyle intervention in primary health-care are feasible. However, the crucial questions still are whether it is possible to replicate the results concerning effectiveness of lifestyle intervention in primary and occupational health-care systems. Furthermore, it remains to be shown whether it is possible to achieve the same results in different health-care settings, cultures, regions and age groups, especially in adolescents and young adults among whom the increase in the incidence has been the highest. In addition, the importance of co-operation among all sections of society, citizens' awareness of healthy lifestyles and the social inequalities in health must be emphasised because the diabetes epidemic cannot be solved only by concentrating on preventive actions carried out by health-care systems.
背景与目标:
背景:在过去的几十年中,芬兰2型糖尿病的患病率一直在上升,与此同时超重和肥胖也逐渐增加。 2型糖尿病患病率的增加带来了并发症,最重要的是CVD。因此,开展预防2型糖尿病的活动极为重要。
目的:本文通过芬兰糖尿病预防研究提供了预防2型糖尿病的临床证据。此外,本文以三种不同类型的预防计划为例,讨论了2型糖尿病预防的实际实施:FIN-D2D,包括风险筛查和初级保健中的反复咨询; FINNAIR,一个针对航空公司员工的针对工作场所的干预项目;以及以社区为基础的预防计划Lahti地区的良好老龄化计划(GOAL)。
结论:FIN-D2D,FINNAIR项目和GOAL计划表明,筛查2型糖尿病的风险并在初级卫生保健中实施大规模的生活方式干预是可行的。但是,关键问题仍然是,是否有可能在初级和职业卫生保健系统中复制有关生活方式干预效果的结果。此外,还有待证明在不同的医疗机构,文化,地区和年龄组中是否有可能获得相同的结果,特别是在青少年和年轻人中,其发病率增加最高。此外,必须强调社会各部门之间合作的重要性,公民对健康生活方式的认识以及健康方面的社会不平等,因为仅通过集中医疗保健系统的预防行动就无法解决糖尿病的流行。