Basic lifestyle advice to individuals at high risk of type 2 diabetes : a 2-year population-based diabetes prevention study. The DE-PLAN intervention in the HUNT Study, Norway

Objective Among individuals at high risk for diabetes identified through a population survey, we performed an intervention study with basic lifestyle advice aiming to prevent diabetes. Research design and methods Among 50 806 participants in the HUNT3 Survey (2006-2008), 5297 individuals with Finnish Diabetes Risc Score (FINDRISC >= 15 were invited to an oral glucose tolerance test (OGTT) and an education session with lifestyle advice, and 2634 (49.7%) attended. Among them, 2380 people without diabetes were included in the prevention study with repeated examinations and education sessions after 6, 12, and 24 months. We examined participation, diabetes incidence, glycemia, and adiposity during follow-up. Results Of 2380 participants, 1212 (50.9%) participated in >= 3 of the four examinations. Diabetes was detected in 3.5%, 3.1%, and 4.0% of individuals at the 6-month, 12-month, and 24-month examinations, respectively, indicating a 10.3% 2-year diabetes incidence. Mean (95% CI) increases from baseline to 2-year follow-up were 0.30 (0.29 to 0.32) percentage points (3.3 (3.2 to 3.5) mmol/mol) for Hemoglobin A 1c, 0.13 (0.10 to 0.16) mmol/L for fasting serum-glucose, 0.46 (0.36 to 0.56) mmol/L for 2-hour OGTT s-glucose, 0.30 (0.19 to 0.40) kg/m(2) forbody mass index (BMI) (all p 5% weight loss during follow-up; their fasting and 2-hour s-glucose did not increase, and HbA 1c increased less than in other participants. Conclusion Basic lifestyle advice given to high-risk individuals during three group sessions with 6-month intervals was not effective in reducing 2-year diabetes risk.Peer reviewe

Validity of the FINDRISC as a prediction tool for diabetes in a contemporary Norwegian population : a 10-year follow-up of the HUNT study

Objective The Finnish Diabetes Risk Score (FINDRISC) is a recommended tool for type 2 diabetes prediction. There is a lack of studies examining the performance of the current 0-26 point FINDRISC scale. We examined the validity of FINDRISC in a contemporary Norwegian risk environment. Research design and methods We followed 47 804 participants without known diabetes and aged >= 20 years in the HUNT3 survey (2006-2008) by linkage to information on glucose-lowering drug dispensing in the Norwegian Prescription Database (2004-2016). We estimated the C-statistic, sensitivity and specificity of FINDRISC as predictor of incident diabetes, as indicated by incident use of glucose-lowering drugs. We estimated the 10-year cumulative diabetes incidence by categories of FINDRISC. Results The C-statistic (95% CI) of FINDRISC in predicting future diabetes was 0.77 (0.76 to 0.78). FINDRISC >= 15 (the conventional cut-off value) had a sensitivity of 38% and a specificity of 90%. The 10-year cumulative diabetes incidence (95% CI) was 4.0% (3.8% to 4.2%) in the entire study population, 13.5% (12.5% to 14.5%) for people with FINDRISC >= 15 and 2.8% (2.6% to 3.0%) for people with FINDRISC = 15 had a positive predictive value of 13.5% and a negative predictive value of 97.2% for diabetes within the next 10 years. To approach a similar sensitivity as in the study in which FINDRISC was developed, we would have to lower the cut-off value for elevated FINDRISC to >= 11. This would yield a sensitivity of 73%, specificity of 67%, positive predictive value of 7.7% and negative predictive value of 98.5%. Conclusions The validity of FINDRISC and the risk of diabetes among people with FINDRISC >= 15 is substantially lower in the contemporary Norwegian population than assumed in official guidelines. To identify similar to 3/4 of those developing diabetes within the next 10 years, we would have to lower the threshold for elevated FINDRISC to >= 11, which would label similar to 1/3 of the entire adult population as having an elevated FINDRISC necessitating a glycemia assessment.Peer reviewe

Période moderne/Époque contemporaine

Période moderne Qu’est-ce qu’une histoire de l’art « hors cadre » selon Hubert Damisch ? Revisiter les sujets phares, de Fra Angelico à l’architecture française ; relire l’art à la lumière des enjeux européens et coloniaux. Époque contemporaine Du XIXe siècle américain aux neurosciences, comment l’histoire de l’art interroge-t-elle les frontières géographiques et disciplinaires ? Atlas, expositions, écrans... autant d’objets d’étude qui poussent à une réflexion sur les méthodes et pratiques contemporaines