Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk – A stop diabetes pragmatic randomised trial

Lakka, Timo A.; Aittola, Kirsikka; Järvelä-Reijonen, Elina; Tilles‐Tirkkonen, Tanja; Männikkö, Reija; Lintu, Niina; Karhunen, Leila; Kolehmainen, Marjukka; Harjumaa, Marja; Mattila, Elina; Järvenpää, Riia; Ermes, Miikka; Mikkonen, Santtu; Martikainen, Janne; Poutanen, Kaisa; Schwab, Ursula; Absetz, Pilvikki; Lindström, Jaana; Pihlajamäki, Jussi

doi:10.1016/j.lanepe.2022.100527

Cited by 9 publications

(9 citation statements)

References 32 publications

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“…Identifier: NCT03156478) carried out within three provinces in Finland (Northern Savo, Southern Carelia, and Päijät‐Häme) as part of the health care system. [ 12,13 ] The general objective of the StopDia study was to create and implement strategies for the prevention of T2D at population level.…”

Section: Methodsmentioning

confidence: 99%

“…Glucose and lipid measurements have been described in detail previously. [ 12,13 ] The disposition index was used as a surrogate measure of early‐phase insulin secretion and the Matsuda index as a surrogate measure of peripheral insulin sensitivity.…”

Section: Methodsmentioning

confidence: 99%

“…To this aim we used cross‐sectional data from the Stop Diabetes (StopDia) study that included 2925 adults at an increased risk of T2D. [ 12,13 ] To our knowledge, this is the first study to investigate the associations of lifestyle patterns, including not only diet and physical activity but also sleep and smoking as well as sociodemographic factors, with several metabolic risk factors in a real‐world setting among adults at increased risk of T2D screened digitally from a general population.…”

Section: Introductionmentioning

confidence: 99%

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Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes

Manninen,

Tilles‐Tirkkonen,

Aittola

et al. 2024

Molecular Nutrition Food Res

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ScopeVarious lifestyle and sociodemographic factors have been associated with risk factors for type 2 diabetes (T2D). However, their combined associations with T2D risk factors have been studied much less.Materials and resultsThis study investigates cross‐sectional associations of lifestyle patterns with T2D risk factors among 2925 adults at increased risk participating in the Stop Diabetes study. Lifestyle patterns are determined using principal component analysis (PCA) with several lifestyle and sociodemographic factors. The associations of lifestyle patterns with measures of glucose and lipid metabolism and serum metabolites analyzed by nuclear magnetic resonance (NMR) spectroscopy are studied using linear regression analysis. “Healthy eating” pattern is associated with better glucose and insulin metabolism, more favorable lipoprotein and fatty acid profiles and lower serum concentrations of metabolites related to inflammation, insulin resistance, and T2D. “High socioeconomic status and low physical activity” pattern is associated with increased serum concentrations of branched‐chain amino acids, as are “Meat and poultry” and “Sleeping hours” patterns. “Snacks” pattern is associated with lower serum concentrations of ketone bodies.ConclusionsOur results show, in large scale primary care setting, that healthy eating is associated with better glucose and lipid metabolism and reveal novel associations of lifestyle patterns with metabolites related to glucose metabolism.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes

Manninen,

Tilles‐Tirkkonen,

Aittola

et al. 2024

Molecular Nutrition Food Res

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“…Building on our implementation evaluation that was reported earlier [ 31 ], the current study evaluated the effectiveness of the StopDia at Work-intervention in a quasi-experimental pre-post design. The intervention was a part of a larger type 2 diabetes prevention study, Stop Diabetes (StopDia), that was approved by the research ethics committee of the hospital district of Northern Savo (statement 467/2016), Trial registration: NCT03156478 [ 33 , 34 ].…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of workplace choice architecture modification for healthy eating and daily physical activity

Rantala,

Vanhatalo,

Valtanen

et al. 2024

BMC Public Health

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Background Modifying the choice architecture of behavioural contexts can facilitate health behaviour change, but existing evidence builds mostly on small-scale interventions limited in duration, targets, strategies, and settings. We evaluated the effectiveness of a one-year hybrid type 2 implementation-effectiveness trial aimed at promoting healthy eating and daily physical activity with subtle modifications to the choice architecture of heterogeneous worksites. The intervention was contextualised to and integrated into the routine operations of each worksite. Effectiveness was evaluated in a quasi-experimental pre-post design. Methods Intervention sites (n = 21) implemented a median of two (range 1–9) intervention strategies for healthy eating and one (range 1–5) for physical activity. Questionnaires pre (n = 1126) and post (n = 943) intervention surveyed employees’ behavioural patterns at work (food consumption: vegetables/roots, fruit/berries, nuts/almonds/seeds, sweet treats, fast food, water; physical activity: restorative movement, exercise equipment use, stair use). The post-intervention questionnaire also measured employees’ perception of and response to three intervention strategies: a packed lunch recipe campaign, a fruit crew-strategy, and movement prompts. Multi- and single-level regression models evaluated effectiveness, treating intervention as a continuous predictor formed of the site-specific dose (n intervention strategies employed) and mean quality (three-point rating per strategy halfway and at the end of the intervention) of implementation relevant to each outcome. Results Multinomial logistic regression models found the intervention significantly associated with a favourable change in employees’ fruit and berry consumption (interaction effect of time and implementation p = 0.006) and with an unfavourable change in sweet treat consumption (p = 0.048). The evidence was strongest for the finding concerning fruit/berry consumption—an outcome that sites with greater dose and quality of implementation targeted by using strategies that reduced the physical effort required to have fruit/berries at work and by covering multiple eating-related contexts at the worksite. The quality of implementation was positively associated with the perception of (p = 0.044) and response to (p = 0.017) the packed lunch recipes, and with response to the fruit crew-strategy (p < 0.001). Conclusions The results suggest that a contextualised, multicomponent choice architecture intervention can positively influence eating behaviour in diverse real-world settings over a one-year period, and that higher implementation quality can enhance intervention perception and response. However, outcomes may depend on the type of intervention strategies used and the extent of their delivery.

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“…This real-world randomised controlled trial (RCT), again from Finland, examined the effectiveness of combined digital and group-based face-to-face delivery of lifestyle interventions to address risk factors for the development of T2DM in an at-risk population. In The Lancet Regional Health – Europe, Lakka et al 4 report the findings of their trial, which was a one-year, multi-centre, unblinded, pragmatic RCT conducted in Finnish primary healthcare in adult patients at increased risk of type 2 diabetes mellitus. 2907 patients, 80% of which were women and with a mean body mass index 31.1 ± 5.4 kg/m 2 were randomised into a digital lifestyle intervention group (n = 967), a combined digital and group-based lifestyle intervention group (n = 971) and a control group (n = 969) receiving usual care.…”

mentioning

confidence: 99%

Type 2 diabetes prevention goes digital

Samarasinghe¹,

Miras²

2023

The Lancet Regional Health - Europe

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Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk – A stop diabetes pragmatic randomised trial

Cited by 9 publications

References 32 publications

Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes

Associations of Lifestyle Patterns with Glucose and Lipid Metabolism in Finnish Adults at Increased Risk of Type 2 Diabetes

Effectiveness of workplace choice architecture modification for healthy eating and daily physical activity

Type 2 diabetes prevention goes digital

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