Diabetes test targets high-risk patients

NEW YORK (Reuters Health) - The Finnish Diabetes Risk Score may help identify high-risk patients who are most likely to benefit from intensive lifestyle intervention to prevent type 2 diabetes, results of a study published in the May issue of Diabetes Care suggest.

"Intensive lifestyle intervention significantly reduced diabetes incidence among the participants in the Finnish Diabetes Prevention Study," Dr. Jaana Lindstrom, of the National Public Health Institute, Helsinki, Finland, and colleagues write. The investigators examined whether and to what extent risk factors for type 2 diabetes and other characteristics of the study subjects modified the effectiveness of the lifestyle intervention.

The Finnish Diabetes Risk Score "combines the effects of eight risk characteristics," the researchers explained -- age, body mass index, waist circumference, drug treatment for high blood pressure, high blood sugar, or "glucose" levels, amount of fruits and vegetables in the diet, physical activity and family history of diabetes.

In the prevention study, 522 overweight, middle-aged subjects with impaired glucose tolerance were randomly assigned to an intensive lifestyle intervention or to a comparison group. The average follow-up was 4 years.

The incidence of diabetes at follow-up was 4.1 cases per 100 persons per year in the intervention group and 7.4 cases per 100 persons per year in the control group.

The investigators found that the intervention was most effective among subjects with a high mark on The Finnish Diabetes Risk Score. That is to say, diabetes incidence across the score categories was constant in the intervention at 4.0 cases per 100 persons per year, but ranged from 3.6 up to 18.8 cases per 100 person-years in the control group.

"Lifestyle intervention is labor-intensive and therefore costly, which is one of the barriers against setting up programs with intensive lifestyle intervention to prevent type 2 diabetes,"Lindstrom and colleagues comment. "The present results suggest that by using the Finish Diabetes Risk Score as a prescreening method, the cost-efficiency of lifestyle interventions could be drastically increased."

Source: Diabetes Care, May 2008.