Results of the implementation of the DP-TRANSFERS project in Catalonia: A translational method to improve diabetes screening and prevention in primary care

Cabré, J.J.; Barrio, F.; Vizcaíno, J.; Martínez, A.; Mur, T.; Sagarra, R.; Dalmau, S.

doi:10.1016/j.rceng.2024.08.003

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Tables (5)

Table 1. Characteristics of the population invited to participate in the screening phase (n = 2381) according to gender, including FINDRISC and analytical data.

Table 2. Comparison of baseline characteristics between participants who were accepted (n = 1713) or excluded (n = 668) from a lifestyle intervention.

Table 3. Evaluation of the resources invested in the intervention during the selection phase (V0-1), the first year — basic module and continuity module-1 (V2-3), and during the second year — continuity module-2 (V4).

Table 4. Initial diabetes risk assessed by FINDRISC and glucose criteria of participants in the DP-TRANSFERS screening step who were accepted to receive the lifestyle intervention (n = 1713).

Table 5. Comparison of baseline anthropometric, biochemical, and lifestyle parameters among participants (n = 1713) according to final diagnosis (diabetes or no diabetes). Only for calculated variables of clinical relevance.

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Abstract

Introduction

DP-TRANSFERS is a translational lifestyle intervention project, which follows a previous protocol described in the DE-PLAN-CAT study.

Objective

Analyze the feasibility of reproducing the intensive intervention and estimating the effect of translation in real conditions of clinical practice in primary care.

Methodology

Implementation of the face-to-face group intervention adjusted to 2 years. After screening, the intervention consisted of a basic module and a continuity module. Stratifying by clusters (health centers), a representative sample (centers, professionals and participants) was evaluated (FINDRISC > 11 and/or prediabetes) from 2016 to 2020. The effect of the intervention on the incidence of diabetes was analyzed.

Results

The intervention, feasible in 95 of 123 centers, involved 343 of 647 professionals. Of 2381 subjects screened, 1713 participated in the basic module, with 1186 participants completing the first year and 776 completing the second. 121 participants (7.06%) were diagnosed with diabetes: 77 (4.49%) during the first year; 44 (2.57%) during the second.

The bivariate analysis showed that those subjects in whom diabetes affected differed in: previous glycemic status, A1c, HDL-cholesterol, FINDRISC score and adherence to the Mediterranean diet, and in the differences between the beginning and end of the study of: body weight, BMI and abdominal circumference.

Conclusions

The intensive intervention substantially reduced (23.6%) the incidence of diabetes compared to that previously estimated in standardized intervention. The following acted as protective factors: a better glycemic status, lower baseline risk, elevated HDL-cholesterol, or achieving a reduction in weight or abdominal circumference during the study.

Keywords:

Epidemology

Diabetes prevention

Type 2 diabetes

Abbreviations:

DE-PLAN

FINDRISC

PREDIMED

DP-TRANSFERS

SC

eCRF

IFG

FPG

IGT

2hPG

OGTT

Resumen

Introducción

DP-TRANSFERS es un proyecto traslacional de la intervención sobre estilos de vida, que sigue un protocolo previo descrito en el estudio DE-PLAN-CAT.

Objetivo

Analizar la factibilidad de reproducir la intervención intensiva y estimar el efecto de la traslación en condiciones reales de práctica clínica en atención primaria.

Metodología

Implementación de la intervención grupal presencial ajustada a 2 años. Tras el cribado, la intervención constó de un módulo básico y otro de continuidad. Estratificando por conglomerados (centros de salud), se evaluó una muestra representativa (centros, profesionales y participantes) (FINDRISC > 11 y/o prediabetes) desde 2016 a 2020. Se analizó del efecto de la intervención sobre la incidencia de diabetes.

Resultados

La intervención, factible en 95 de 123 centros, involucró a 343 de 647 profesionales. De 2381 sujetos cribados, 1713 participaron en el módulo básico, completando el primer año 1186 participantes y 776 finalizaron el segundo. Se diagnosticó diabetes a 121 participantes (7,06%): 77 (4,49%) durante el primer año; 44 (2,57%) durante el segundo.

El análisis bivariante objetivó que aquellos sujetos en quienes incidió la diabetes, diferían en: estado glucémico previo, A1c, HDL-colesterol, puntuación FINDRISC y adherencia a dieta mediterránea, y en las diferencias entre inicio y final de estudio de: peso corporal, IMC y perímetro abdominal.

Conclusiones

La intervención intensiva redujo sustancialmente (23,6%) la incidencia de diabetes en comparación con aquella previamente estimada en intervención estandarizada. Actuaron como factores protectores: un mejor estado glucémico, menor riesgo basal, colesterol-HDL elevado, o conseguir reducción del peso o del perímetro abdominal durante el estudio.

Palabras clave:

Epidemiología

Prevención de diabetes

Diabetes tipo 2

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