Clinical trial NCT00518167: The Finnish Diabetes Prevention Study
Official title: The Finnish Diabetes Prevention Study: A Follow-up Study on the Effect of a Dietary and Exercise Intervention in the Prevention of Diabetes and Its Vascular Complications
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Type 2 Diabetes
Keywords: Type 2 diabetes
primary prevention
diet
physical activity
intervention
impaired glucose tolerance
lifestyle
randomized controlled study
Lead sponsor: Finnish Institute for Health and Welfare
Sponsor class: OTHER_GOV
Collaborators: name: University of Eastern Finland
name: Finnish Diabetes Association
name: University of Oulu
First posted: 2007-08-20
Enrollment: 522
Sex: ALL
Minimum age (years): 40
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: The aim of this study is to clarify whether lifestyle intervention provided to people with high type 2 diabetes risk will lower the cumulative incidence of diabetes. Furthermore, the aim is to study the effect of lifestyle intervention on cardiovascular risk.


Eligibility criteria: Inclusion Criteria:

* impaired glucose tolerance (p-glucose 2 hours after a 75 g oral glucose load between 7.8 and 11.0 mmol/l)
* body mass index 25 or higher

Exclusion Criteria:

* diabetes (previous gestational diabetes accepted)
* other chronic disease rendering survival for 6 years
* condition or medication affecting glucose tolerance
* recent myocardial infarction

Primary outcomes:
measure: Diabetes incidence
timeFrame: During the intervention period + after the intervention has been stopped
Secondary outcomes:
measure: CVD incidence
timeFrame: During the total follow up
Other outcomes:
Locations:
city: Helsinki
country: Finland
facility: Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare
city: Kuopio
country: Finland
facility: Institute of Public Health and Clinical Nutrition, University of Eastern Finland
city: Oulu
country: Finland
facility: Department of Sports Medicine, Oulu Deaconess Institute
city: Tampere
country: Finland
facility: The Diabetes Center, Finnish Diabetes Association
Study officials:
affiliation: Finnish Institute for Health and Welfare and University of Helsinki
name: Jaakko Tuomilehto, professor emeritus
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Eastern Finland
name: Matti Uusitupa, professor emeritus
role: PRINCIPAL_INVESTIGATOR
References:
citation: Eriksson J, Lindstrom J, Valle T, Aunola S, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Lauhkonen M, Lehto P, Lehtonen A, Louheranta A, Mannelin M, Martikkala V, Rastas M, Sundvall J, Turpeinen A, Viljanen T, Uusitupa M, Tuomilehto J. Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia. 1999 Jul;42(7):793-801. doi: 10.1007/s001250051229.
citation: Lindgren P, Lindstrom J, Tuomilehto J, Uusitupa M, Peltonen M, Jonsson B, de Faire U, Hellenius ML; DPS Study Group. Lifestyle intervention to prevent diabetes in men and women with impaired glucose tolerance is cost-effective. Int J Technol Assess Health Care. 2007 Spring;23(2):177-83. doi: 10.1017/S0266462307070286.
citation: Laitinen T, Lindstrom J, Eriksson J, Ilanne-Parikka P, Aunola S, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M. Cardiovascular autonomic dysfunction is associated with central obesity in persons with impaired glucose tolerance. Diabet Med. 2011 Jun;28(6):699-704. doi: 10.1111/j.1464-5491.2011.03278.x.
citation: Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Rastas M, Salminen V, Uusitupa M; Finnish Diabetes Prevention Study Group. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001 May 3;344(18):1343-50. doi: 10.1056/NEJM200105033441801.
citation: Eriksson J, Valle T, Lindstrom J, Haffner S, Louheranta A, Uusitupa M, Tuomilehto J. Leptin concentrations and their relation to body fat distribution and weight loss--a prospective study in individuals with impaired glucose tolerance. DPS-study group. Horm Metab Res. 1999 Nov;31(11):616-9. doi: 10.1055/s-2007-978807.
citation: Uusitupa M, Louheranta A, Lindstrom J, Valle T, Sundvall J, Eriksson J, Tuomilehto J. The Finnish Diabetes Prevention Study. Br J Nutr. 2000 Mar;83 Suppl 1:S137-42. doi: 10.1017/s0007114500001070.
citation: Lindi VI, Uusitupa MI, Lindstrom J, Louheranta A, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Laakso M, Tuomilehto J; Finnish Diabetes Prevention Study. Association of the Pro12Ala polymorphism in the PPAR-gamma2 gene with 3-year incidence of type 2 diabetes and body weight change in the Finnish Diabetes Prevention Study. Diabetes. 2002 Aug;51(8):2581-6. doi: 10.2337/diabetes.51.8.2581.
citation: Kubaszek A, Pihlajamaki J, Komarovski V, Lindi V, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study. Promoter polymorphisms of the TNF-alpha (G-308A) and IL-6 (C-174G) genes predict the conversion from impaired glucose tolerance to type 2 diabetes: the Finnish Diabetes Prevention Study. Diabetes. 2003 Jul;52(7):1872-6. doi: 10.2337/diabetes.52.7.1872.
citation: Uusitupa M, Lindi V, Louheranta A, Salopuro T, Lindstrom J, Tuomilehto J; Finnish Diabetes Prevention Study Group. Long-term improvement in insulin sensitivity by changing lifestyles of people with impaired glucose tolerance: 4-year results from the Finnish Diabetes Prevention Study. Diabetes. 2003 Oct;52(10):2532-8. doi: 10.2337/diabetes.52.10.2532.
citation: Lindstrom J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003 Dec;26(12):3230-6. doi: 10.2337/diacare.26.12.3230.
citation: Todorova B, Kubaszek A, Pihlajamaki J, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study. The G-250A promoter polymorphism of the hepatic lipase gene predicts the conversion from impaired glucose tolerance to type 2 diabetes mellitus: the Finnish Diabetes Prevention Study. J Clin Endocrinol Metab. 2004 May;89(5):2019-23. doi: 10.1210/jc.2003-031325.
citation: Laukkanen O, Pihlajamaki J, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study Group. Common polymorphisms in the genes regulating the early insulin signalling pathway: effects on weight change and the conversion from impaired glucose tolerance to Type 2 diabetes. The Finnish Diabetes Prevention Study. Diabetologia. 2004 May;47(5):871-7. doi: 10.1007/s00125-004-1395-6. Epub 2004 May 1.
citation: Siitonen N, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M, Uusitupa M. Association between a deletion/insertion polymorphism in the alpha2B-adrenergic receptor gene and insulin secretion and Type 2 diabetes. The Finnish Diabetes Prevention Study. Diabetologia. 2004 Aug;47(8):1416-24. doi: 10.1007/s00125-004-1462-z. Epub 2004 Jul 28.
citation: Ilanne-Parikka P, Eriksson JG, Lindstrom J, Hamalainen H, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Rastas M, Salminen V, Aunola S, Sundvall J, Valle T, Lahtela J, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Prevalence of the metabolic syndrome and its components: findings from a Finnish general population sample and the Diabetes Prevention Study cohort. Diabetes Care. 2004 Sep;27(9):2135-40. doi: 10.2337/diacare.27.9.2135.
citation: Salopuro T, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M, Uusitupa M. Common variants in beta2- and beta3-adrenergic receptor genes and uncoupling protein 1 as predictors of the risk for type 2 diabetes and body weight changes. The Finnish Diabetes Prevention Study. Clin Genet. 2004 Oct;66(4):365-7. doi: 10.1111/j.1399-0004.2004.00313.x. No abstract available.
citation: Laukkanen O, Pihlajamaki J, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study Group. Polymorphisms of the SUR1 (ABCC8) and Kir6.2 (KCNJ11) genes predict the conversion from impaired glucose tolerance to type 2 diabetes. The Finnish Diabetes Prevention Study. J Clin Endocrinol Metab. 2004 Dec;89(12):6286-90. doi: 10.1210/jc.2004-1204.
citation: Laaksonen DE, Lindstrom J, Lakka TA, Eriksson JG, Niskanen L, Wikstrom K, Aunola S, Keinanen-Kiukaanniemi S, Laakso M, Valle TT, Ilanne-Parikka P, Louheranta A, Hamalainen H, Rastas M, Salminen V, Cepaitis Z, Hakumaki M, Kaikkonen H, Harkonen P, Sundvall J, Tuomilehto J, Uusitupa M; Finnish diabetes prevention study. Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes. 2005 Jan;54(1):158-65. doi: 10.2337/diabetes.54.1.158.
citation: Lindstrom J, Peltonen M, Tuomilehto J. Lifestyle strategies for weight control: experience from the Finnish Diabetes Prevention Study. Proc Nutr Soc. 2005 Feb;64(1):81-8. doi: 10.1079/pns2004412.
citation: Laukkanen O, Lindstrom J, Eriksson J, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study. Polymorphisms in the SLC2A2 (GLUT2) gene are associated with the conversion from impaired glucose tolerance to type 2 diabetes: the Finnish Diabetes Prevention Study. Diabetes. 2005 Jul;54(7):2256-60. doi: 10.2337/diabetes.54.7.2256.
citation: Salopuro T, Pulkkinen L, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M, Uusitupa M; Finnish Diabetes Prevention Study Group. Genetic variation in leptin receptor gene is associated with type 2 diabetes and body weight: The Finnish Diabetes Prevention Study. Int J Obes (Lond). 2005 Oct;29(10):1245-51. doi: 10.1038/sj.ijo.0803024.
citation: Hamalainen H, Ronnemaa T, Virtanen A, Lindstrom J, Eriksson JG, Valle TT, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Rastas M, Aunola S, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Improved fibrinolysis by an intensive lifestyle intervention in subjects with impaired glucose tolerance. The Finnish Diabetes Prevention Study. Diabetologia. 2005 Nov;48(11):2248-53. doi: 10.1007/s00125-005-1938-5. Epub 2005 Oct 5.
citation: Niskanen L, Laaksonen DE, Lindstrom J, Eriksson JG, Keinanen-Kiukaanniemi S, Ilanne-Parikka P, Aunola S, Hamalainen H, Tuomilehto J, Uusitupa M. Serum uric acid as a harbinger of metabolic outcome in subjects with impaired glucose tolerance: the Finnish Diabetes Prevention Study. Diabetes Care. 2006 Mar;29(3):709-11. doi: 10.2337/diacare.29.03.06.dc05-1465. No abstract available.
citation: Lindstrom J, Peltonen M, Eriksson JG, Louheranta A, Fogelholm M, Uusitupa M, Tuomilehto J. High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study. Diabetologia. 2006 May;49(5):912-20. doi: 10.1007/s00125-006-0198-3. Epub 2006 Mar 16.
citation: Siitonen N, Pulkkinen L, Mager U, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M, Uusitupa M. Association of sequence variations in the gene encoding adiponectin receptor 1 (ADIPOR1) with body size and insulin levels. The Finnish Diabetes Prevention Study. Diabetologia. 2006 Aug;49(8):1795-805. doi: 10.1007/s00125-006-0291-7. Epub 2006 May 25.
citation: Mager U, Lindi V, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M, Pulkkinen L, Uusitupa M; Finnish Diabetes Prevention Study Group. Association of the Leu72Met polymorphism of the ghrelin gene with the risk of Type 2 diabetes in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study. Diabet Med. 2006 Jun;23(6):685-9. doi: 10.1111/j.1464-5491.2006.01870.x.
citation: Herder C, Peltonen M, Koenig W, Kraft I, Muller-Scholze S, Martin S, Lakka T, Ilanne-Parikka P, Eriksson JG, Hamalainen H, Keinanen-Kiukaanniemi S, Valle TT, Uusitupa M, Lindstrom J, Kolb H, Tuomilehto J. Systemic immune mediators and lifestyle changes in the prevention of type 2 diabetes: results from the Finnish Diabetes Prevention Study. Diabetes. 2006 Aug;55(8):2340-6. doi: 10.2337/db05-1320.
citation: Mager U, Kolehmainen M, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto JO, Pulkkinen L, Uusitupa MI; Finnish Diabetes Prevention Study Group. Association between ghrelin gene variations and blood pressure in subjects with impaired glucose tolerance. Am J Hypertens. 2006 Sep;19(9):920-6. doi: 10.1016/j.amjhyper.2006.02.017.
citation: Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, Hamalainen H, Harkonen P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006 Nov 11;368(9548):1673-9. doi: 10.1016/S0140-6736(06)69701-8.
citation: Laaksonen DE, Siitonen N, Lindstrom J, Eriksson JG, Reunanen P, Tuomilehto J, Uusitupa M; Finnish Diabetes Prevention Study Group. Physical activity, diet, and incident diabetes in relation to an ADRA2B polymorphism. Med Sci Sports Exerc. 2007 Feb;39(2):227-32. doi: 10.1249/01.mss.0000246998.02095.bf.
citation: Ottelin AM, Lindstrom J, Peltonen M, Martikainen J, Uusitupa M, Gylling H, Poutanen K, Louheranta A, Mannelin M, Paturi M, Salminen V, Tuomilehto J; Finnish Diabetes Prevention Study Group. Costs of a self-selected, health-promoting diet among the participants of the Finnish Diabetes Prevention Study. Diabetes Care. 2007 May;30(5):1275-7. doi: 10.2337/dc06-2444. Epub 2007 Feb 26. No abstract available.
citation: Wang J, Kuusisto J, Vanttinen M, Kuulasmaa T, Lindstrom J, Tuomilehto J, Uusitupa M, Laakso M. Variants of transcription factor 7-like 2 (TCF7L2) gene predict conversion to type 2 diabetes in the Finnish Diabetes Prevention Study and are associated with impaired glucose regulation and impaired insulin secretion. Diabetologia. 2007 Jun;50(6):1192-200. doi: 10.1007/s00125-007-0656-6. Epub 2007 Apr 17.
citation: Tolppanen AM, Pulkkinen L, Kolehmainen M, Schwab U, Lindstrom J, Tuomilehto J, Uusitupa M; Finnish Diabetes Prevention Study Group. Tenomodulin is associated with obesity and diabetes risk: the Finnish diabetes prevention study. Obesity (Silver Spring). 2007 May;15(5):1082-8. doi: 10.1038/oby.2007.613.
citation: Kilpelainen TO, Lakka TA, Laaksonen DE, Laukkanen O, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Aunola S, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M, Laakso M; Finnish Diabetes Prevention Study Group. Physical activity modifies the effect of SNPs in the SLC2A2 (GLUT2) and ABCC8 (SUR1) genes on the risk of developing type 2 diabetes. Physiol Genomics. 2007 Oct 22;31(2):264-72. doi: 10.1152/physiolgenomics.00036.2007. Epub 2007 Jul 17.
citation: Uusitupa M, Peltonen M, Lindstrom J, Aunola S, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Valle TT, Eriksson JG, Tuomilehto J; Finnish Diabetes Prevention Study Group. Ten-year mortality and cardiovascular morbidity in the Finnish Diabetes Prevention Study--secondary analysis of the randomized trial. PLoS One. 2009 May 21;4(5):e5656. doi: 10.1371/journal.pone.0005656.
citation: Pajunen P, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Keinanen-Kiukaanniemi S, Uusitupa M, Tuomilehto J, Lindstrom J; Finnish Diabetes Prevention Study. HbA(1c) in diagnosing and predicting Type 2 diabetes in impaired glucose tolerance: the Finnish Diabetes Prevention Study. Diabet Med. 2011 Jan;28(1):36-42. doi: 10.1111/j.1464-5491.2010.03183.x.
citation: Kivela J, Meinila J, Uusitupa M, Tuomilehto J, Lindstrom J. Longitudinal Branched-Chain Amino Acids, Lifestyle Intervention, and Type 2 Diabetes in the Finnish Diabetes Prevention Study. J Clin Endocrinol Metab. 2022 Sep 28;107(10):2844-2853. doi: 10.1210/clinem/dgac463.
citation: Penn L, White M, Lindstrom J, den Boer AT, Blaak E, Eriksson JG, Feskens E, Ilanne-Parikka P, Keinanen-Kiukaanniemi SM, Walker M, Mathers JC, Uusitupa M, Tuomilehto J. Importance of weight loss maintenance and risk prediction in the prevention of type 2 diabetes: analysis of European Diabetes Prevention Study RCT. PLoS One. 2013;8(2):e57143. doi: 10.1371/journal.pone.0057143. Epub 2013 Feb 25.
citation: Lindstrom J, Peltonen M, Eriksson JG, Ilanne-Parikka P, Aunola S, Keinanen-Kiukaanniemi S, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study (DPS). Improved lifestyle and decreased diabetes risk over 13 years: long-term follow-up of the randomised Finnish Diabetes Prevention Study (DPS). Diabetologia. 2013 Feb;56(2):284-93. doi: 10.1007/s00125-012-2752-5. Epub 2012 Oct 24.
citation: de Mello VD, Lindstrom J, Eriksson J, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Sundvall J, Laakso M, Tuomilehto J, Uusitupa M. Insulin secretion and its determinants in the progression of impaired glucose tolerance to type 2 diabetes in impaired glucose-tolerant individuals: the Finnish Diabetes Prevention Study. Diabetes Care. 2012 Feb;35(2):211-7. doi: 10.2337/dc11-1272. Epub 2011 Dec 30.
citation: Siitonen N, Pulkkinen L, Lindstrom J, Kolehmainen M, Schwab U, Eriksson JG, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M. Association of ADIPOR2 gene variants with cardiovascular disease and type 2 diabetes risk in individuals with impaired glucose tolerance: the Finnish Diabetes Prevention Study. Cardiovasc Diabetol. 2011 Sep 24;10:83. doi: 10.1186/1475-2840-10-83.
citation: Siitonen N, Pulkkinen L, Lindstrom J, Kolehmainen M, Eriksson JG, Venojarvi M, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Uusitupa M. Association of ADIPOQ gene variants with body weight, type 2 diabetes and serum adiponectin concentrations: the Finnish Diabetes Prevention Study. BMC Med Genet. 2011 Jan 10;12:5. doi: 10.1186/1471-2350-12-5.
citation: Uusitupa MI, Stancakova A, Peltonen M, Eriksson JG, Lindstrom J, Aunola S, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Tuomilehto J, Laakso M. Impact of positive family history and genetic risk variants on the incidence of diabetes: the Finnish Diabetes Prevention Study. Diabetes Care. 2011 Feb;34(2):418-23. doi: 10.2337/dc10-1013. Epub 2010 Oct 27.
citation: Ilanne-Parikka P, Laaksonen DE, Eriksson JG, Lakka TA, Lindstr J, Peltonen M, Aunola S, Keinanen-Kiukaanniemi S, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Leisure-time physical activity and the metabolic syndrome in the Finnish diabetes prevention study. Diabetes Care. 2010 Jul;33(7):1610-7. doi: 10.2337/dc09-2155. Epub 2010 Apr 22.
citation: Tuomilehto H, Peltonen M, Partinen M, Lavigne G, Eriksson JG, Herder C, Aunola S, Keinanen-Kiukaanniemi S, Ilanne-Parikka P, Uusitupa M, Tuomilehto J, Lindstrom J; Finnish Diabetes Prevention Study Group. Sleep duration, lifestyle intervention, and incidence of type 2 diabetes in impaired glucose tolerance: The Finnish Diabetes Prevention Study. Diabetes Care. 2009 Nov;32(11):1965-71. doi: 10.2337/dc08-1980. Epub 2009 Aug 3.
citation: Herder C, Peltonen M, Koenig W, Sutfels K, Lindstrom J, Martin S, Ilanne-Parikka P, Eriksson JG, Aunola S, Keinanen-Kiukaanniemi S, Valle TT, Uusitupa M, Kolb H, Tuomilehto J; Finnish Diabetes Prevention Study Group. Anti-inflammatory effect of lifestyle changes in the Finnish Diabetes Prevention Study. Diabetologia. 2009 Mar;52(3):433-42. doi: 10.1007/s00125-008-1243-1. Epub 2009 Jan 8.
citation: Lindstrom J, Peltonen M, Eriksson JG, Aunola S, Hamalainen H, Ilanne-Parikka P, Keinanen-Kiukaanniemi S, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study (DPS) Group. Determinants for the effectiveness of lifestyle intervention in the Finnish Diabetes Prevention Study. Diabetes Care. 2008 May;31(5):857-62. doi: 10.2337/dc07-2162. Epub 2008 Feb 5.