Effect of lifestyle intervention on the risk of incident diabetes in individuals with impaired fasting glucose and low or high genetic risk for the development of type 2 diabetes in men: a T2D-GENE trial

  • Ursula Schwab School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio; and Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
  • Maria Lankinen School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
  • Markku Laakso Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio Campus and Kuopio University Hospital, Kuopio, Finland
DOI: https://doi.org/10.29219/fnr.v65.7721
Keywords: diet, genotype, genetic risk, glucose metabolism, physical activity, type 2 diabetes

Abstract

Purpose: Genetic and lifestyle/environmental factors as well as their interplay contribute to the pathogenesis of type 2 diabetes (T2D). Several trials have shown that lifestyle intervention is effective in the prevention of T2D, but there are no trials that have taken into account the genetic risk of the participants. The aim of our T2D-GENE trial (ClinicalTrials.gov ID: NCT02709057) is to investigate the effects of lifestyle intervention on the prevention of T2D in participants with a high genetic risk of T2D compared with participants with a low genetic risk of T2D.

Methods: Both intervention and control groups include 300 participants with low and 300 participants with high genetic risk for T2D. Genetic risk was evaluated by genetic risk score, and these two groups were matched additionally for fasting plasma glucose concentration, age, and body mass index. Corresponding control groups (300 participants each) do not have lifestyle intervention. The inclusion criteria are impaired fasting glucose at entry with or without impaired glucose tolerance, age 50–75 years, and body mass index ≥25 kg/m2. The primary outcome is incident T2D and the intervention lasts for 3 years.

Conclusion: If the effects of the lifestyle intervention are independent from the genetic risk of the participants, our study will be of great importance for the entire T2D research community, health care providers, and individuals at high risk for T2D. In this case, lifestyle intervention is beneficial for all individuals at risk for developing T2D, independently of genetic risk.

Downloads

Download data is not yet available.

References


  1. IDF Diabetes Atlas. 9th ed. 2019. Available from: https://www.idf.org/aboutdiabetes [cited 16 February 2021].

  2. Mahajan A, Taliun D, Thurner M, Robertson NR, Torres JM, Rayner NW, et al. Fine-mapping of an expanded set of type 2 diabetes loci to single-variant resolution using high-density imputation and islet-specific epigenome maps. Nature Genetics 2018; 50: 1505–13. doi: 10.1038/s41588-018-0241-6

  3. Laakso M. Biomarkers for type 2 diabetes. Mol Metab 2019; 27S: S139–46. doi: 10.1016/j.molmet.2019.06.016

  4. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–50. doi: 10.1056/NEJM200105033441801

  5. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393–403. doi: 10.1056/NEJMoa012512

  6. Faerch K, Borch-Johnsen K, Holst JJ, Vaag A. Pathophysiology and aetiology of impaired fasting glycaemia and impaired glucose tolerance: does it matter for prevention and treatment of type 2 diabetes? Diabetologia 2009; 52: 1714–23. doi: 10.1007/s00125-009-1443-3

  7. Edwards CM, Cusi K. Prediabetes: a worldwide epidemic. Endocrinol Metab Clin North Am 2016; 45: 751–64. doi: 10.1016/j.ecl.2016.06.007

  8. Merlotti C, Morabito A, Pontiroli AE. Prevention of type 2 diabetes; a systematic review and meta-analysis of different intervention strategies. Diabetes Obes Metab 2014; 16: 719–27. doi: 10.1111/dom.12270

  9. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2013; 36: S67–74. doi: 10.2337/dc13-S067

  10. Laakso M, Kuusisto J, Stancakova A, Kuulasmaa T, Pajukanta P, Lusis AJ, et al. The metabolic syndrome in men study: a resource for studies of metabolic and cardiovascular diseases. J Lipid Res 2017; 58: 481–93. doi: 10.1194/jlr.O072629

  11. Stancakova A, Kuulasmaa T, Kuusisto J, Mohlke KL, Collins FS, Boehnke M, et al. Genetic risk scores in the prediction of plasma glucose, impaired insulin secretion, insulin resistance and incident type 2 diabetes in the METSIM study. Diabetologia 2017; 60: 1722–30. doi: 10.1007/s00125-017-4313-4

  12. Karlsson J, Persson LO, Sjöström L, Sullivan M. Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord 2000; 24: 1715–25. doi: 10.1038/sj.ijo.0801442

  13. Nordic Council of Ministers. Nordic nutrition recommendations 2012. Integrating nutrition and physical activity. Nordic Council of Ministers; 2014.

  14. Saaristo T, Aro E, Huttunen J, Hyytiä A, Ilanne-Parikka P, Järvi H, et al. Implementation of type 2 diabetes prevention plan in Pirkanmaa, South Ostrobothnia, North Ostrobothnia, Northern Savo and Central Finland Hospital Districts. Project plan 2013–2007. Finnish Diabetes Association; 2006. Available from: https://www.diabetes.fi/files/1107/Implementation_of_Type_2_Diabetes_Prevention._Project_Plan_2003-2007.pdf [cited 16 February 2021].

  15. National Institute for Health and Welfare. 2015 The FINRISKI 2007 study. Available from: http://urn.fi/URN:NBN:fi-fe201204193298 [cited 16 February 2021].

  16. Takkunen M, Agren J, Kuusisto J, Laakso M, Uusitupa M, Schwab U. Dietary fat in relation to erythrocyte fatty acid composition in men. Lipids 2013; 48: 1093–102. doi: 10.1007/s11745-013-3832-0

  17. Haw JS, Galaviz KI, Straus AN, Kowalski AJ, Magee MJ, Weber MB, et al. Long-term sustainability of diabetes prevention approaches: a systematic review and meta-analysis of randomized clinical trials. JAMA Intern Med 2017; 177: 1808–17. doi: 10.1001/jamainternmed.2017.6040

  18. Uusitupa M, Khan TA, Viguiliouk E, Kahleova H, Rivellese AA, Hermansen K, Pfeiffer A, et al. Prevention of type 2 diabetes by lifestyle changes: a systematic review and meta-analysis. Nutrients 2019; 11: 2611. doi: 10.3390/nu11112611

  19. Galaviz KI, Weber MB, Straus A, Haw JS, Narayan KMV, Ali MK. Global diabetes prevention interventions: a systematic review and network meta-analysis of the real-world impact on incidence, weight, and glucose. Diabetes Care 2018; 41: 1526–34. doi: 10.2337/dc17-2222

Published
2021-09-23
How to Cite
Schwab U., Lankinen M., & Laakso M. (2021). Effect of lifestyle intervention on the risk of incident diabetes in individuals with impaired fasting glucose and low or high genetic risk for the development of type 2 diabetes in men: a T2D-GENE trial. Food & Nutrition Research, 65. https://doi.org/10.29219/fnr.v65.7721
Issue
Vol 65 (2021)
Section
Study Protocols
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors retain copyright of their work, with first publication rights granted to SNF Swedish Nutrition Foundation. Read the full Copyright- and Licensing Statement.

 

 

Crossref
Scopus
Google Scholar
Europe PMC