As a pioneering study in diabetes prevention, the Finnish Diabetes Prevention Study showed that lifestyle improvements decreased diabetes incidence in patients with impaired glucose tolerance. The same group of investigators also developed an algorithm for the prediction of diabetes. Known as FINDRISC, the algorithm takes into account age, body mass index, waist circumference, history of anti-hypertensive drug use, previously measured high blood glucose, consumption of fruits and vegetables, physical activity, and family history of diabetes. In the study, Lindstrom et al. sought to identify the main determinants of the effectiveness of this lifestyle intervention therapy. They reported that intervention success was greater in older subjects, as participants in the top age tertile had a hazard ratio (HR) for future diabetes of 0.36 (95% CI, 0.17-0.80) compared to participants in the bottom tertile [HR=0.77 (95% CI, 0.44-1.38). The FINDRISC was also an important determinant of the effectiveness of the intervention, as participants with the highest FINDRISC had a HR for future diabetes of 0.22 (95% CI, 0.06-0.88) compared to the group with the lowest FINDRISC [HR=1.09 (95% CI, 0.38-3.09)]. The authors concluded that participants at greater risk of developing diabetes are those who are more likely to benefit from lifestyle intervention therapy. They also suggested that the FINDRISC might be useful in identifying subjects at increased diabetes risk.
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