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

J.J. Cabré , F. Barrio , J. Vizcaíno , A. Martínez , T. Mur , R. Sagarra , S. Dalmau
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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.
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在加泰罗尼亚地区实施 DP-TRANSFERS 项目的结果:在初级保健中改进糖尿病筛查和预防的转化方法。
项目简介DP-TRANSFERS是一个生活方式干预转化项目,它沿用了DE-PLAN-CAT研究中描述的先前方案:分析在初级保健临床实践的实际条件下复制强化干预的可行性,并估计转化的效果:方法:将面对面小组干预的实施时间调整为 2 年。筛查后,干预包括基本模块和持续模块。按照群组(医疗中心)进行分层,从2016年至2020年对代表性样本(中心、专业人员和参与者)进行评估(FINDRISC>11和/或糖尿病前期)。分析了干预措施对糖尿病发病率的影响:干预措施在 123 个中心中的 95 个可行,647 名专业人员中有 343 人参与。在筛选出的 2381 名受试者中,1713 人参加了基础模块,其中 1186 人完成了第一年的学习,776 人完成了第二年的学习。121名参与者(7.06%)被诊断出患有糖尿病:77人(4.49%)在第一年被诊断出患有糖尿病;44人(2.57%)在第二年被诊断出患有糖尿病。双变量分析显示,受糖尿病影响的受试者在以下方面存在差异:之前的血糖状况、A1c、高密度脂蛋白胆固醇、FINDRISC评分和对地中海饮食的坚持程度,以及研究开始和结束时体重、体重指数和腹围的差异:结论:与之前在标准化干预中估计的糖尿病发病率相比,强化干预大大降低了糖尿病发病率(23.6%)。以下因素起到了保护作用:较好的血糖状况、较低的基线风险、较高的高密度脂蛋白胆固醇,或在研究期间实现了体重或腹围的减少。
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