{"id":1678,"date":"2020-07-07T18:24:03","date_gmt":"2020-07-07T15:24:03","guid":{"rendered":"https:\/\/sites.uef.fi\/stopdia\/?page_id=1678"},"modified":"2023-12-22T08:39:52","modified_gmt":"2023-12-22T06:39:52","slug":"background-and-theory","status":"publish","type":"page","link":"https:\/\/sites.uef.fi\/stopdia\/background-and-theory\/?lang=en","title":{"rendered":"Background and theory"},"content":{"rendered":"\n<figure class=\"wp-block-image aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"225\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/StopDia_Logo_Pysty-300x225.png\" alt=\"\" class=\"wp-image-1981\" srcset=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/StopDia_Logo_Pysty-300x225.png 300w, https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/StopDia_Logo_Pysty-768x576.png 768w, https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/StopDia_Logo_Pysty.png 800w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n\n\n\n<p>Previous clinical trials have shown the efficacy of lifestyle interventions in the prevention of type 2 diabetes in different populations [1, 2, 3, 4] and the sustainability of the beneficial effects for several years after the discontinuation of the intervention [5, 6].<\/p>\n\n\n\n<p>The efficacy of such interventions depends strongly on the lifestyle changes adopted, which emphasizes successful health behavior change in the prevention of type 2 diabetes [5]. Importantly, sustainable and scalable models are needed to reach and identify individuals at increased risk of type 2 diabetes and to deliver personalized and effective lifestyle interventions.<\/p>\n\n\n\n<p>The implementation of evidence-based approaches for reaching and identifying individuals at increased risk and preventing type 2 diabetes as permanent practices in the health care system and the society is still a challenge. Individuals at increased risk can be identified based on a history of non-diabetic dysglycaemia or gestational diabetes [7, 8] but also using validated risk screening tools, such as the Finnish Diabetes Risk Score (FINDRISC) [9]. However, such risk screening tools are not yet utilized systematically in the identification of individuals at increased risk of type 2 diabetes in the health care system and the society.<\/p>\n\n\n\n<p>Many seminal lifestyle intervention studies, such as the Diabetes Prevention Study in Finland [1] and the Diabetes Prevention Program in the United States [2] as well as most of the implementation studies following these efficacy trials [10, 11] have been based on face-to-face counselling either individually or in groups.<\/p>\n\n\n\n<p>However, individual counseling is resource-intensive and may not be feasible for most health care systems [10]. Group counseling demands less resources but requires special skills [12] which may limit its use in the health care system. Although digital interventions are more scalable than face-to-face interventions, adherence to digital interventions remains a challenge [13, 14].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Stop Diabetes \u2013 Knowledge-Based Solutions (StopDia): A Strategic Reseach Funding project<\/h2>\n\n\n\n<p>The Stop Diabetes (StopDia) study was set to create and implement evidence-based and digitally supported strategies for the prevention of type 2 diabetes at population level in three provinces in Finland.<\/p>\n\n\n\n<p>The project received funding from the Strategic Recearch Council on June 2016. The Strategic Research Council (SRC) funds high-quality research that has great societal impact. The research should seek to find concrete solutions to grand challenges that require multidisciplinary approaches. An important element of such research is active collaboration between those who produce new knowledge and those who use it.<\/p>\n\n\n\n<p>Importantly, the risk identification and the StopDia lifestyle interventions are fully integrated in the Finnish health care system to facilitate their long-term implementation.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Tuomilehto J, Lindstr\u00f6m J, Eriksson JG, Valle TT, H\u00e4m\u00e4l\u00e4inen 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(18):1343\u201350. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=11333990\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Prevention%20of%20type%202%20diabetes%20mellitus%20by%20changes%20in%20lifestyle%20among%20subjects%20with%20impaired%20glucose%20tolerance&amp;author=J.%20Tuomilehto&amp;author=J.%20Lindstr%C3%B6m&amp;author=JG.%20Eriksson&amp;author=TT.%20Valle&amp;author=H.%20H%C3%A4m%C3%A4l%C3%A4inen&amp;author=P.%20Ilanne-Parikka&amp;journal=N%20Engl%20J%20Med&amp;volume=344&amp;issue=18&amp;pages=1343-1350&amp;publication_year=2001\">Google Scholar<\/a><\/li>\n\n\n\n<li>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(6):393\u2013403. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=11832527\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Reduction%20in%20the%20incidence%20of%20type%202%20diabetes%20with%20lifestyle%20intervention%20or%20metformin&amp;author=WC.%20Knowler&amp;author=E.%20Barrett-Connor&amp;author=SE.%20Fowler&amp;author=RF.%20Hamman&amp;author=JM.%20Lachin&amp;author=EA.%20Walker&amp;journal=N%20Engl%20J%20Med&amp;volume=346&amp;issue=6&amp;pages=393-403&amp;publication_year=2002\">Google Scholar<\/a><\/li>\n\n\n\n<li>Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD, Vijay V. The Indian diabetes prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia. 2006;49(2):289\u201397. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=16391903\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=The%20Indian%20diabetes%20prevention%20Programme%20shows%20that%20lifestyle%20modification%20and%20metformin%20prevent%20type%202%20diabetes%20in%20Asian%20Indian%20subjects%20with%20impaired%20glucose%20tolerance%20%28IDPP-1%29&amp;author=A.%20Ramachandran&amp;author=C.%20Snehalatha&amp;author=S.%20Mary&amp;author=B.%20Mukesh&amp;author=AD.%20Bhaskar&amp;author=V.%20Vijay&amp;journal=Diabetologia.&amp;volume=49&amp;issue=2&amp;pages=289-297&amp;publication_year=2006\">Google Scholar<\/a><\/li>\n\n\n\n<li>Telle-Hjellset V, Kj\u00f8llesdal MKR, Bj\u00f8rge B, Holmboe-Ottesen G, Wandel M, Birkeland KI, et al. The InnvaDiab-DE-PLAN study: a randomised controlled trial with a culturally adapted education programme improved the risk profile for type 2 diabetes in Pakistani immigrant women. Br J Nutr. 2013;109(3):529\u201338. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=22717286\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=The%20InnvaDiab-DE-PLAN%20study%3A%20a%20randomised%20controlled%20trial%20with%20a%20culturally%20adapted%20education%20programme%20improved%20the%20risk%20profile%20for%20type%202%20diabetes%20in%20Pakistani%20immigrant%20women&amp;author=V.%20Telle-Hjellset&amp;author=MKR.%20Kj%C3%B8llesdal&amp;author=B.%20Bj%C3%B8rge&amp;author=G.%20Holmboe-Ottesen&amp;author=M.%20Wandel&amp;author=KI.%20Birkeland&amp;journal=Br%20J%20Nutr&amp;volume=109&amp;issue=3&amp;pages=529-538&amp;publication_year=2013\">Google Scholar<\/a><\/li>\n\n\n\n<li>Lindstr\u00f6m J, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Kein\u00e4nen-Kiukaanniemi S, et al. Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish diabetes prevention study (DPS). Diabetologia. 2013;56(2):284\u201393. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=23093136\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Improved%20lifestyle%20and%20decreased%20diabetes%20risk%20over%2013%20years%3A%20long-term%20follow-up%20of%20the%20randomised%20Finnish%20diabetes%20prevention%20study%20%28DPS%29&amp;author=J.%20Lindstr%C3%B6m&amp;author=M.%20Peltonen&amp;author=JG.%20Eriksson&amp;author=P.%20Ilanne-Parikka&amp;author=S.%20Aunola&amp;author=S.%20Kein%C3%A4nen-Kiukaanniemi&amp;journal=Diabetologia.&amp;volume=56&amp;issue=2&amp;pages=284-293&amp;publication_year=2013\">Google Scholar<\/a><\/li>\n\n\n\n<li>Diabetes Prevention Program Research Group. Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the diabetes prevention program outcomes study. Lancet Diabetes Endocrinol. 2015;3(11):866\u201375. &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4623946\">PubMed Central<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Long-term%20effects%20of%20lifestyle%20intervention%20or%20metformin%20on%20diabetes%20development%20and%20microvascular%20complications%20over%2015-year%20follow-up%3A%20the%20diabetes%20prevention%20program%20outcomes%20study&amp;journal=Lancet%20Diabetes%20Endocrinol&amp;volume=3&amp;issue=11&amp;pages=866-875&amp;publication_year=2015\">Google Scholar<\/a><\/li>\n\n\n\n<li>Bellamy L, Casas J-P, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773\u20139. &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=19465232\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Type%202%20diabetes%20mellitus%20after%20gestational%20diabetes%3A%20a%20systematic%20review%20and%20meta-analysis&amp;author=L.%20Bellamy&amp;author=J-P.%20Casas&amp;author=AD.%20Hingorani&amp;author=D.%20Williams&amp;journal=Lancet.&amp;volume=373&amp;issue=9677&amp;pages=1773-1779&amp;publication_year=2009\">Google Scholar<\/a><\/li>\n\n\n\n<li>Morris DH, Khunti K, Achana F, Srinivasan B, Gray LJ, Davies MJ, et al. Progression rates from HbA1c 6.0\u20136.4% and other prediabetes definitions to type 2 diabetes: a meta-analysis. Diabetologia. 2013;56(7):1489\u201393. &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=23584433\">PubMed<\/a> &nbsp; &nbsp; <a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=Progression%20rates%20from%20HbA1c%206.0%E2%80%936.4%25%20and%20other%20prediabetes%20definitions%20to%20type%202%20diabetes%3A%20a%20meta-analysis&amp;author=DH.%20Morris&amp;author=K.%20Khunti&amp;author=F.%20Achana&amp;author=B.%20Srinivasan&amp;author=LJ.%20Gray&amp;author=MJ.%20Davies&amp;journal=Diabetologia.&amp;volume=56&amp;issue=7&amp;pages=1489-1493&amp;publication_year=2013\">Google Scholar<\/a><\/li>\n\n\n\n<li>Lindstr\u00f6m J, Tuomilehto J. The diabetes risk score: a practical tool to predict type 2 diabetes risk. Diabetes Care. 2003;26(3):725\u201331. &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=12610029\">PubMed<\/a> &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=The%20diabetes%20risk%20score%3A%20a%20practical%20tool%20to%20predict%20type%202%20diabetes%20risk&amp;author=J.%20Lindstr%C3%B6m&amp;author=J.%20Tuomilehto&amp;journal=Diabetes%20Care&amp;volume=26&amp;issue=3&amp;pages=725-731&amp;publication_year=2003\">Google Scholar<\/a><\/li>\n\n\n\n<li>Aziz Z, Absetz P, Oldroyd J, Pronk NP, Oldenburg B. A systematic review of real-world diabetes prevention programs: learnings from the last 15 years. Implement Sci. 2015;10(1):172. &nbsp; &nbsp; <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Abstract&amp;list_uids=26670418\">PubMed<\/a> &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4681022\">PubMed Central<\/a> &nbsp;&nbsp; &nbsp;<a href=\"http:\/\/scholar.google.com\/scholar_lookup?title=A%20systematic%20review%20of%20real-world%20diabetes%20prevention%20programs%3A%20learnings%20from%20the%20last%2015%20years&amp;author=Z.%20Aziz&amp;author=P.%20Absetz&amp;author=J.%20Oldroyd&amp;author=NP.%20Pronk&amp;author=B.%20Oldenburg&amp;journal=Implement%20Sci&amp;volume=10&amp;issue=1&amp;pages=172&amp;publication_year=2015\">Google Scholar<\/a><\/li>\n<\/ol>\n\n\n    <div class=\"funders grid\">\n                        <div class=\"funders__item grid__item\">\n                            <div class=\"funders__image\">\n                    <img decoding=\"async\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2021\/01\/University_of_eastern_finland_logo.jpg\" alt=\"It\u00e4-Suomen yliopiston logo.\" \/>\n                <\/div>\n                                                <\/div>\n                        \n                        <div class=\"funders__item grid__item\">\n                            <div class=\"funders__image\">\n                    <img decoding=\"async\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/THL_tunnus_lyhyt_RGB_vihrea-1-1.jpg\" alt=\"Terveyden ja hyvinvoinnin laitoksen (THL) logo.\" \/>\n                <\/div>\n                                                <\/div>\n                        \n                        <div class=\"funders__item grid__item\">\n                            <div class=\"funders__image\">\n                    <img decoding=\"async\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/07\/VTT_Orange_Logo-1.jpg\" alt=\"VTT:n logo.\" \/>\n                <\/div>\n                                                <\/div>\n                        \n            <\/div>\n\n\n    <div class=\"funders grid\">\n                        <div class=\"funders__item grid__item\">\n                            <div class=\"funders__image\">\n                    <img decoding=\"async\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2020\/08\/Suomen-Akatemia.jpg\" alt=\"Suomen Akatemia logo.\" \/>\n                <\/div>\n                                                <\/div>\n                        \n                        <div class=\"funders__item grid__item\">\n                            <div class=\"funders__image\">\n                    <img decoding=\"async\" src=\"https:\/\/sites.uef.fi\/stopdia\/wp-content\/uploads\/sites\/90\/2021\/01\/Suomen-akatemia_Strateginen-tutkimus_logo.jpg\" alt=\"Suomen Akatemia, strateginen tutkimus logo.\" \/>\n                <\/div>\n                                                <\/div>\n                        \n            <\/div>\n","protected":false},"excerpt":{"rendered":"<p>Previous clinical trials have shown the efficacy of lifestyle interventions in the prevention of type 2 diabetes in different populations [1, 2, 3, 4] and the sustainability of the beneficial effects for several years after the discontinuation of the intervention [5, 6]. The efficacy of such interventions depends strongly on the lifestyle changes adopted, which [&hellip;]<\/p>\n","protected":false},"author":187,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-1678","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Background and theory - StopDia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sites.uef.fi\/stopdia\/background-and-theory\/?lang=en\" \/>\n<meta property=\"og:locale\" content=\"fi_FI\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Background and theory - StopDia\" \/>\n<meta property=\"og:description\" content=\"Previous clinical trials have shown the efficacy of lifestyle interventions in the prevention of type 2 diabetes in different populations [1, 2, 3, 4] and the sustainability of the beneficial effects for several years after the discontinuation of the intervention [5, 6]. 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