The effects of adding group-based lifestyle counselling to individual counselling on changes in plasma glucose levels in a randomized controlled trial: the Inter99 study

Diabetes Metab. 2011 Dec;37(6):546-52. doi: 10.1016/j.diabet.2011.06.001. Epub 2011 Sep 6.

Abstract

Aim: This study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes.

Methods: In a population-based study of 6784 participants, 4053 were determined to be at high risk based on a risk estimate of ischaemic heart disease or the presence of risk factors (smoking, hypertension, hypercholesterolaemia, obesity, impaired glucose tolerance). Of these subjects, 90% were randomized to high-intensity intervention (group A) and 10% to low-intensity intervention (group B). All participants went through health examinations, risk assessments and individual lifestyle counselling. Participants in group A were further offered group-based lifestyle counselling. The intervention was repeated after 1 and 3 years. A total of 2738 participants free of diabetes at baseline (1999-2001) and with at least one FPG and/or 2hPG measurement during 5 years of follow-up were included in the analyses. Differences in changes of plasma glucose between groups A and B were analyzed using multilevel linear regression.

Results: For FPG, crude 5-year changes were significantly different between the two groups (group A: -0.003 mmol/L vs group B: -0.079 mmol/L; P=0.0427). After adjusting for relevant confounders, no differences in FPG changes were observed (P=0.116). Also, no significant differences in the 5-year changes in 2hPG between the two groups were observed (group A: - 0.127 mmol/L vs group B: -0.201 mmol/L; P=0.546).

Conclusion: Offering additional group-based intervention to a high-risk population subgroup had no clinical effects on changes in plasma glucose beyond those of individualized multifactorial interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism*
  • Counseling*
  • Denmark / epidemiology
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes Mellitus, Type 2 / psychology
  • Diet
  • European Continental Ancestry Group
  • Exercise
  • Female
  • Follow-Up Studies
  • Glucose Intolerance / epidemiology*
  • Glucose Intolerance / prevention & control
  • Humans
  • Hypertension / blood
  • Hypertension / prevention & control
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / prevention & control*
  • Obesity / psychology
  • Risk Factors
  • Risk Reduction Behavior*
  • Smoking / adverse effects
  • Smoking / blood*
  • Smoking / psychology
  • Smoking Prevention
  • Surveys and Questionnaires

Substances

  • Blood Glucose