Projects

Lifestyle changes can reduce the risk of developing type 2 diabetes mellitus. The evaluated aha!2.0 program (“Different from today!”) focuses on the recognition of the diabetes mellitus type 2 risk and on the modification of lifestyle to reduce known risk factors. The aim of aha!2.0 was to estimate the point prevalence of participating individuals with a very high risk of type 2 diabetes mellitus in Schleswig-Holstein at the start of the study using FINDRISK. Furthermore, the development of the relevant endpoints body weight, waist circumference and body mass index was investigated.

Methods

The study was conducted between July 2014 and December 2016 in a single-arm longitudinal study design and 15-month follow-up (including 12 weeks of intervention) with a total of five control time points (t-1 to t3). Study participants were recruited in family practices in Schleswig-Holstein. Legally insured individuals aged 18 years and older who had identifiable abdominal obesity and/or a relevant family history and/or a sedentary lifestyle were included. The intervention consisted of the FINDRISK test (Module 1), which estimates the ten-year risk of developing type 2 diabetes mellitus by means of a score, and the lifestyle intervention itself (Module 2). Building on a doctor-insured discussion, participants received the aha! starter set, consisting of a Chip List©, a diet and exercise diary, an exercise band with exercise poster and a measuring tape to measure waist circumference.

Results

The point prevalence for individuals with a very high risk (50% according to FINDRISK) of developing type 2 diabetes mellitus in the next ten years was 12.2% [95% CI: 10.3, 14.5] in the population of individuals recruited in GP practices in Schleswig-Holstein with a GP-suspected type 2 diabetes mellitus risk. The 205 participants who completed the program over the 15-month follow-up period reduced their body weight by 4.5 kg [CI-95%: -5.6, -3.4], their waist circumference by -5.7 cm [95%-CI: -6.5, -4.7], and their body mass index by 1.6 kg/m² [95%-CI: -2.0, -1.2].

Conclusion

aha!2.0 proved to be implementable in Schleswig-Holstein. Participants were able to reduce modifiable risk factors for type 2 diabetes mellitus during the 15-month follow-up. Data from 205 of the original 935 participants (21.9%) could be evaluated at the last follow-up. Future studies of lifestyle interventions related to reduction of behavioral risk factors of DMT2 in the primary care setting should evaluate the effect of adherence-enhancing interventions.

Building on the results of aha!2.0, the project Dimini – Diabetes mellitus? Not for me! followed, which was funded by the Innovation Fund at the Federal Joint Committee from 2017 to 2020.

Publication

Binder, S., Püschner, F., Bertram, N., Weber, V., Amelung, V. E., Göhl, M. & Petersen, C. (2019). Lebensstilintervention Aha!2.0 zur Reduktion von modifizierbaren Risikofaktoren des Diabetes mellitus Typ 2 bei Risikopersonen: eine Longitudinalstudie im Hausarztsetting in Schleswig-Holstein. Diabetologie Und Stoffwechsel. https://doi.org/10.1055/a-0903-2468

Foto: freepik