The Research Of The Effect Of Intensive Lifestyle Intervention To The Metabolic Markers In Impaired Glucose Regulation In Community

Objective To determine the prevalence and risk factors of Diabetes Millitus(DM) and ImPaired Glucose Regulation(IGR) in community of Tai Yuan city. For the IGR subjects which selected in the first part,we take lifestyle intervention for 3 months, to evaluate the effect of the intervention.Methods The research includes two parts. Firstly, A random, cluster sampling was conducted,and 5000 dwellers in Ying ze community of Tai Yuan city were investigated. Secondly, there were 90 subjecets with IGR who were randomized to either a usual care control group or an intensive lifestyle intervention group. The control group received general dietary and exercise advice once a month. The subjects in the intervention group received additional individualized dietary counseling.They were also offered circuit-type resistance training sessions and advised to increase overall physical activity. The intervention goals were to describe the change of metabolic markers after 3 months.Results 1. The prevalence of DM was 16.88 %,with 6.11 % in man, and 10.77% in women. The prevalence of IGR was 7.28%, and 2.34% in man, and 4.95% in women. There were 167 newly-diagnosed DM patients, accounting for 24.10 % of total DM patients in the investigation.2. The prevalences of DM and IGR were increasing with an age increase after 45 years of age in female ( P <0.01) ; The prevalences of DM were increasing with an age increase after 45 years of age in male ( P < 0.01).3. The parameters of age, TG, TC and FPG were gradually increased in size or level in the order of the severity of dysglycemia from Normal glucose tolerance(NGT) to IGR and to DM groups ( P < 0.05) , and were higher ,except for the lower HDL-c,in IGR and DM groups than in NGT group. While the BMI,SBP,DBPand serum uric acid were the highest in IGR group.4. In logistic regression analysis, age, TG, LDL, SBP were the risk factors for IGR and DM. And HDL-c was a protective factor.5. The intervention group showed significantly greater improvement in each intervention goal. After 3 months, OGTT2hPG and HOMA-IR were improved in the intervention group compared to 3 months ago. BMI,SBP,DBP,FPG,OGTT2hPG,TC,LDL-c and HbA1C were improved in the intervention group compared to the control group(P<0.05).Conclusions1. The prevalence rates of DM and IGR in Tai Yuan, Shan Xi province were high. Dyslipidemia, aging and hypertension are the risk factors for DM and IGR.2. The intensive lifestyle intervention significantly greater improved the metabolic markers of IGR subjects in community. This type of intervention is a feasible option to prevent type 2 diabetes and should be implemented in the community of Tai Yuan, Shan Xi province.