DELIGHT (Delay of impaired glucose tolerance by a healthy lifestyle trial) – A Feasibility Study on Implementing a Program of Sustainable Diabetes Prevention in German Companies

Abstract

Background:

Ca. 50% of Germans develop prediabetes in their lifetime. Though diabetes type 2 has been proven preventable, no screening for prediabetes has been implemented. DELIGHT was designed to assess if screening for individuals at risk and long-standing diabetes prevention is feasible in the setting of companies within the scope of the German legal health system.

Materials and Methods:

In 5 companies employees with a waist circumference of ≥ 94 (men) and ≥ 80 cm (women) were offered a check-up. Those with fasting plasma glucose ≥ 100 mg/dl (IFG) or ≥ 140 mg/dl 2 h after oral glucose load (IGT) were followed for 3 years with an optional moderate lifestyle program during the first year and quarterly assistance for another 2 years.

Results:

In 241 of 300 participants the self-measured waist circumference was confirmed as elevated. 3% had type 2 diabetes, while 37% had IFG (isolated in 96%) or IGT, of whom 91.4% (men) and 76.1% (women) had a metabolic syndrome. Within 3 years in those who had lost ≥ 1 kg, weight was reduced by 3.9 kg, risk factors were improved, and no case of diabetes had developed, while among those with weight loss of < 1 kg or weight gain, 10% of men and 5% of women had developed diabetes type 2. Screening for prediabetes did not increase the number or costs of drug prescriptions.

Conclusions:

Companies provide a suitable setting for screening for prediabetes. Long-term diabetes prevention is successfully feasible within the narrow financial frame of a legal insurance system without rise of costs.

Key words

prediabetes - diabetes type 2 - prevention - setting - nutrition - physical activity

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