Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Feasibility of a Diabetes Prevention Program at Nationwide Level in General Practice: A Pilot Study in Italy

Version 1 : Received: 17 January 2024 / Approved: 19 January 2024 / Online: 19 January 2024 (09:15:29 CET)

A peer-reviewed article of this Preprint also exists.

La Grotta, R.; Pellegrini, V.; Prattichizzo, F.; Amata, O.; Panella, L.; Frizziero, A.; Visconti, M.; Averame, G.; Brasesco, P.C.; Calabrese, I.; Vaccaro, O.; Ceriello, A. Feasibility of a Type 2 Diabetes Prevention Program at Nationwide Level in General Practice: A Pilot Study in Italy. J. Clin. Med. 2024, 13, 1127. La Grotta, R.; Pellegrini, V.; Prattichizzo, F.; Amata, O.; Panella, L.; Frizziero, A.; Visconti, M.; Averame, G.; Brasesco, P.C.; Calabrese, I.; Vaccaro, O.; Ceriello, A. Feasibility of a Type 2 Diabetes Prevention Program at Nationwide Level in General Practice: A Pilot Study in Italy. J. Clin. Med. 2024, 13, 1127.

Abstract

Lifestyle interventions halt the progression of prediabetes to frank type 2 diabetes (T2D). However, the feasibility of a diabetes prevention program promoting tailored interventions on a national scale and conducted by primary care physicians is unclear. To explore this issue, general practitioners dislocated in ten different regions throughout Italy enrolled random subjects without known metabolic diseases to identify individuals with prediabetes and prescribe them an intervention based on physical activity. Using a simple stepwise approach, people referring to their primary care physician for any reason were screened for their diabetes risk with a web-based app of the Findrisc questionnaire. Those at risk for T2D, i.e. with a Findrisc score > 9, were invited to come back after overnight fasting to measure fasting glycaemia (FG). Those with 100 ≤ FG < 126 mg/dL were considered as people with prediabetes and compiled the Physical Activity Readiness Questionnaire (PAR-Q) to then receive a personalized prescription of physical activity. Overall, 5928 people were enrolled and compiled the questionnaire. Of these, 2895 (48.8 %) were at risk for T2D. Among these, FG was measured in 2168 subjects (participation rate 75%). The numbers of individuals with undetected prediabetes and T2D according to FG were 755 and 79 (34.8% and 3.6% of those assessing FG), respectively. Of the 755 subjects in the prediabetes range, 739 compiled the PAR-Q and started a personalized program of physical activity (participation rate 97%). Physicians involved in the study reported a mean of 6 minutes to perform the screening. Overall, these data suggest the feasibility of a national diabetes prevention program developed by general practitioners using a simple stepwise approach starting from a web-app to intercept individuals with prediabetes.

Keywords

Type 2 diabetes; screening; prediabetes; prevention; physical activity; Findrisc; PAR-Q

Subject

Medicine and Pharmacology, Endocrinology and Metabolism

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