# Maritime Health Research and Education-NET/The International Type 2 Diabetes Mellitus and Hypertension Research Group/Learning from Interventions in non-maritime workplaces
## Interventions in maritime workplaces for metabolic syndrome

Results of a systematic review show that a limited number of studies of lifestyle interventions in the maritime setting exist and that the quality of them is generally modest. Also, most of the interventions identified have failed to demonstrate substantial health benefits for seafarersThis is consistent with the overall assessment that reduction of the risk factors for the metabolic syndrome in the general populations lead to poor results, while focusing on T2DM in the workplace has shown to be effective in many studies. By learning from the good results of interventions in non-maritime workplaces with focus on early detection of T2DM we expect promising results in the maritime setting. Moreover seafarers have to come for a medical examination every two years to get their permission to sail as seafarers there will be almost 100% participation in the screening program, There will be only small additional costs to include screening for type two diabetes and hypertension and an expectation of that the screening in the maritime group is a success compared to other work groups.

## Interventions in non-maritime workplaces

Effectiveness of a Type 2 Diabetes Screening Intervention in the Canadian Workplace 2018
The effectiveness was evaluated of a diabetes screening and education pilot program, in the workplace, combined with screening meetings by telephone with a certified diabetes educator (n=293). At baseline, 21% were identified as having pre-diabetes (13%) or having diabetes (8%). Statistically significant reductions in glycated hemoglobin levels from baseline to the study's end after 6 months were observed in those with pre-diabetes or diabetes. No statistically significant changes in glycated hemoglobin levels were observed in individuals with normal levels or in those at risk for diabetes at baseline. Conclusions: workplace interventions may reduce employees' diabetes risk levels and are valued by employees.
Effectiveness of a Type 2 Diabetes Prevention Program Combining FINDRISC Scoring 2020
A screening survey using the FINDRISC score was conducted coaching program including 6 monthly interviews together with a final evaluation interview three months later. Dietary knowledge/behavior continued to improve in the 581 completers (+0.17, P = 0.0001).
Effectiveness of Workplace Interventions to Reduce the Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis
Workplace type 2 diabetes (T2D) prevention programs vary in intervention, delivery and methodologic approaches. The participants in (Diabetes Prevention Program) DPP-based interventions were 3.85 more likely to show a weight loss of ≥5%. Conclusions DPP interventions in the workplace continue to be an important and worthwhile strategy. Our review shows that such programs reveal promising evidence for weight loss and improved physical activities with less intensive and structured supports.
Measuring Risk Online Feasibility of Using FINDRISC in an Online Workplace Survey
The total number of responders to Webb-QPS was 3581 (69%). Of those responding 3029 (84%) replied to the FINDRISC section which comprises 59% of the original population. A group of 1082 high risk individuals could be considered for intervention whereof 298 (9.8%) are expected to develop diabetes the upcoming 10 years if left without intervention. It is feasible to incorporate a diabetes risk score such as the FINDRISC in a workplace survey. A group that could be subject to preventive intervention programs was identified.
Diabetes screening and prevention in a large chemical company
From April 2011 to June 2013 12.114 employees participated in the general health check offered by the medical department (2.530 women, 9.584 men). All participants filled out a questionnaire named “Findrisk” a scientifically validated questionnaire which focuses on risk factors for diabetes. Furthermore, the blood glucose and the HbA1c of the participants have also been checked in a laboratory test. In 243 employees a manifest diabetes disease with HbA1c of > than 6,5 % was diagnosed. We found out that diabetes prevention within the workplace setting is helpful to detect prediabetes and diabetes earlier than family doctors outside the company are able to do. Occupational physicians have the opportunity to inform the employees on risks for lifestyle diseases at an early stage when they are still healthy (primary prevention). For secondary prevention surveillance and clearance examination can be easily combined with screening tests for diabetes. For further diagnostics and therapy the family doctors will be addressed. This system helps individuals to prevent negative health effects, it helps the employer to reduce incapacity time and it also helps the state health system to safe money for therapy and rehabilitation
The Cost-Effectiveness of Screening for Type 2 Diabetes
The Motivaction program involves a voluntary web-based diabetes health-risk assessment, the Canadian Diabetes Risk Questionnaire (CANRISK), combined with an opportunity for those eligible (i.e. having diabetes or having a CANRISK score ≥21) to attend 2 on-site biometric screening meetings with a registered nurse and 4 educational sessions by telephone with a certified diabetes educator. Biometric data, as well as information about self-efficacy, lifestyle changes, productivity, well-being, mental health and program satisfaction, were collected at baseline and at 6 months. Attendance at the initial and 6-month clinical visits included 293 people. At baseline, 21% were identified as having prediabetes (13%) or having diabetes (8%). Statistically significant reductions in glycated hemoglobin levels from baseline to the study's end were observed in those with prediabetes or diabetes. No statistically significant changes in glycated hemoglobin levels were observed in individuals with normal levels or in those at risk for diabetes at baseline. No statistical differences were observed in terms of productivity or mental health for the full population or across diabetes-risk categories. More than 90% of employees would recommend the Motivaction program to other employers. This study provides a framework for future diabetes interventions in the workplace and demonstrates that workplace interventions may reduce employees' diabetes risk levels and are valued by employees.