The Effects Of Diet And Physical Exercise Interventions On Diabetes Risk And Risk Factors

Objective: In 3 years follow-up study of "Qingdao diabetes prevention program",comparing with the long-term effects of diabetes prevention between no project area and the project area of diet and exercise intervention.To verify the feasibility of the implementation of diet and physical exercise intervention in the community and provide the basis for early intervention in asymptomatic patients delayed the onset of diabetes.Methods: A total of 5110 subjects were selected from the Qingdao diabetes prevention program(a survey of 6,100 subjects conducted in a large-scale baseline survey)since 2009.The response rate is 83.77% and a total of 831 patients with diabetes were excluded from the study.The remaining 4279 subjects were followed up for a period of up to 3 years.The project area included Shinan District,Jiaonan City,Huangdao district;the non-project area included Sifang District,Jimo city.The project area did 3 years of diet and exercise intervention on and non-project areas did not receive any intervention.Questionnaire,physical examination and laboratory examination were carried out for baseline population and follow-up population.Compare with the changes of body weight,fasting plasma glucose,postprandial 2 hours blood glucose,total cholesterol,triglycerides,high-density lipoprotein cholesterol and other indicators in the project and non-project areas before and after intervention.Results: Prevalence of diabetes was 16.3% in 2009.3 years of follow-up of 4279 subjects received a total number of valid questionnaires in 2312 cases,including 1456 cases in the project area and 856 cases in the no project area.200 patients with newly diagnosed diabetes were followed up for a period of 3 years.The cumulative incidence of diabetes was 8.7%.Diet and exercise interventions were negatively correlated with the onset of diabetes.Diet and exercise intervention,blood pressure,family history of diabetes can predict diabetes,but there was no statistically significant difference on smoking,drinking and BMI.The RR value of diet and physical activity(95% CI)was 0.58(0.41-0.81),a protective factor for diabetes.The RR value of blood pressure and its(95% CI)was 2.02(1.45 ~ 2.81),and the RR value of family history of diabetes and its(95% CI)was 2.03(1.39 ~ 2.95).They are a risk factor for diabetes.The weight and systolic blood pressure were decreased in the project area,and were increased in the non-project area.The difference was statistically significant(P<0.05).Fasting blood glucose,high density lipoprotein cholesterol is reduced in the project area and project area,but reduced obviously in the project area.The difference between the two groups was statistically significant(P<0.05);The waist circumference,waist-to-hip ratio in the project area were increased lower than the non-project area,and the two groups were statistically significant(P<0.05).Diastolic pressure in the project area was increased higher than the non-project area,and the two groups were statistically significant(P < 0.05).The change of postprandial 2 hours blood glucose in the project area was higher than in the non-project area,and the two groups were statistically significant(P<0.05).Triglycerides,total cholesterol and Hb A1 c were reduced in the non-project area,and increased in the project area,and the difference was statistically significant(P<0.05).The difference of BMI between the two groups was not statistically significant(P>0.05).Conclusion: Diet and exercise intervention can improve patient weight,effective control the blood glucose and lipid metabolism,reduce the risk of diabetes in high-risk groups and provide a scientific basis for the asymptomatic population doing early diet and exercise interventions to delay the onset of diabetes.