Prevention of type 2 diabetes in a primary healthcare setting: Three-year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance

<p>Abstract</p> <p>Background</p> <p>A randomized control trial was performed to test whether a lifestyle intervention program, carried out in a primary healthcare setting using existing resources, can reduce the incidence of type 2 diabetes in Japanese with impaired glucose tolerance (IGT). The results of 3 years' intervention are summarized.</p> <p>Methods</p> <p>Through health checkups in communities and workplaces, 304 middle-aged IGT subjects with a mean body mass index (BMI) of 24.5 kg/m²were recruited and randomized to the intervention group or control group. The lifestyle intervention was carried out for 3 years by public health nurses using the curriculum and educational materials provided by the study group.</p> <p>Results</p> <p>After 1 year, the intervention had significantly improved body weight (-1.5 ± 0.7 vs. -0.7 ± 2.5 kg in the control; p = 0.023) and daily non-exercise leisure time energy expenditure (25 ± 113 vs. -3 ± 98 kcal; p = 0.045). Insulin sensitivity assessed by the Matsuda index was improved by the intervention during the 3 years. The 3-year cumulative incidence tended to be lower in the intervention group (14.8% vs.8.2%, log-rank test: p = 0.097). In a sub-analysis for the subjects with a BMI > 22.5 kg/m², a significant reduction in the cumulative incidence was found (p = 0.027).</p> <p>Conclusions</p> <p>The present lifestyle intervention program using existing healthcare resources is beneficial in preventing diabetes in Japanese with IGT. This has important implications for primary healthcare-based diabetes prevention.</p> <p>Trial registration number</p> <p><b>UMIN000003136</b></p

The order Kiloniellales

The Kiloniellaceae family is represented currently by a single genus Kiloniella with the species Kiloniella laminariae as type species. Kiloniella laminariae was isolated from the marine macroalga Saccharina latissima (former Laminaria saccharina) obtained from the Baltic Sea. The bacterium is a mesophilic, typical marine bacterium. It is a chemoheterotrophic aerobic bacterium with the potential of denitrification. Growth optima are at 25 °C, pH 5.5, and 3 % NaCl. The distinguished phylogenetic position separates Kiloniella from other alphaproteobacterial orders. The 16S rRNA gene sequence revealed a distant relationship to species of several orders of the Alphaproteobacteria with less than 91 % sequence similarity. This gives rise to the recognition of Kiloniella as a representative of a new order of the Alphaproteobacteria, the Kiloniellales. Phylogenetic analyses revealed a distinct cluster of Kiloniella with an uncharacterized bacterium (isolate KOPRI 13522) from hydrothermal plumes. This cluster forms a larger group together with the distantly related Terasakiella pusilla (88.4 % sequence similarity of the 16S rRNA gene) and the Thalassospira species (88.9–90.2 % sequence similarity). These genera are supposed to form separate families within the Kiloniellales