بررسی تاثیر اصلاح شیوه زندگی بر بروز دیابت نوع دوم در طی یک

Abstract: Background: Studies show that a change in lifestyle can prevent or delay progression to diabetes in people with glucose intolerance. This study aimed to survey the effects of lifestyle changes on incidence of type II diabetes in Tehran adult population. Materials and methods: This was a community based interventional study. Non-diabetic participants of Tehran Lipid and Glucose Study aged ≥20 years (6437 in control group and 2931 in intervention group) were followed for a mean duration of 3.5 years. The changes in lifestyle included an improvement in diet, increase in the level of physical activity and quitting smoking. Mantel-Cox method was used to compare the incidence of diabetes between the groups. The Cox proportional hazard was used to obtain the proportional risk of diabetes in the intervention group. Results: 58% of subjects completed the follow-up examination for an average period of 3.5 years. The mean age of the study population was 43±11 years, 41% were males. The percentage of increase in weight, waist circumference, serum triglyceride and blood glucose in the intervention group was lower than controls [0.6 vs. 3.3% for fasting glucose, 5.4 vs. 10.6% for 2-hours glucose, 1.2 vs. 6.4% for triglyceride, 4.5 vs. 5.7% for waist circumference (P<0.01) and 2.5 vs. 3.2% for weight (P<0.01)]. Incidence of diabetes was 12.2/1000 person-year in control group and 8.2/1000 person-year for case group. Relative risk of developing diabetes was significantly lower in the intervention groups after adjusting for confounding factors, (hazard ratio 0.34, 95%CI: [0.25-0.47], P<0.001). Number needed to treat to prevent one case of diabetes was 25, 5.7, and 6.7 respectively for the whole population, those with impaired glucose tolerance, and those with body mass index ≥ 25 kg/m². Conclusion: This study showed that after changes in lifestyle for 3.5 years, there was more than 65% reduction in the incidence of diabetes in the Tehranian adult population. KEYWORDS: type II diabetes, incidence, life style modification.