Interventions for the prevention of risk factors and incidence of type 2 diabetes in the work environment: a systematic review

Inolopú, Jorge; Hilario-Huapaya, Nélida; Tantaleán-Del-Águila, Martín Alonso; Hurtado-Roca, Yamilee; Ugarte-Gil, Cesar

doi:10.11606/s1518-8787.2019053001084

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Review • Rev. Saúde Pública 53 • 2019 • https://doi.org/10.11606/s1518-8787.2019053001084 linkcopy

Interventions for the prevention of risk factors and incidence of type 2 diabetes in the work environment: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To evaluate the effectiveness of interventions aimed at the prevention of risk factors and incidence of type 2 diabetes in the workers population.

METHODS Systematic review of interventions aimed at adult workers at risk of type 2 diabetes published in Medline, Embase, Web of Science, Central Cochrane Registry of Controlled Trials, and Lilacs. Randomized trials, quasi-experimental research and cohort studies were selected; in English, Spanish and Portuguese; published from 2000 to 2017. Intervention effectiveness was evaluated concerning the incidence of type 2 diabetes and a significant reduction in body weight, or another anthropometric or metabolic parameter.

RESULTS 3,024 articles were generated, of which 2,825 that did not answer the research question were eliminated, as well as 130 that did not evaluate original interventions, 57 carried out outside the workplace and two reviews; so that 10 selected items remained. Interventions based on structured programs previously evaluated and integrated into the workplace had a favorable impact on the reduction of body weight and other risk factors.

CONCLUSIONS The effectiveness of lifestyle interventions for the prevention of type 2 diabetes should be based on structured programs with proven effectiveness and adapted to the workplace, with employer participation in the provision of schedules and work environments.

Type 2 Diabetes Mellitus, prevention & control; Assessment, Outcome (Health Care); Working Environment; Review

Pubmed: ((“Cohort Studies”[Mesh] OR “Clinical Trial” [Publication Type]) AND ((“2000/01/01”[Date - Publication] : “2017/30/12”[Date - Publication]))) AND (“Adult”[Mesh] OR “Occupational Groups”[Mesh] OR “Occupational Health Nursing”[Mesh] OR “Workplace”[Mesh] OR (“Occupational Groups”[Mesh] AND “Population”[Mesh]) OR Work-related[All Fields] OR Worksite[All Fields] OR Working population[All Fields] OR Economically active population[All Fields]) AND (“Occupational Health”[Mesh] OR “Primary Prevention”[Mesh] OR “Occupational Health Services”[Mesh] OR “Preventive Health Services”[Mesh] OR “Complementary Therapies”[Mesh] OR “Integrative Medicine”[Mesh] OR “Models, Organizational”[Mesh] OR “Behavior Therapy”[Mesh] OR “Tai Ji”[Mesh] OR “Yoga”[Mesh] OR “Qigong”[Mesh]) AND (“Diabetes Mellitus, Type 2” [Mesh]) AND (Diabetes Mellitus, Type 2/prevention and control[MAJR] OR “Prediabetic State”[Mesh] OR “Hyperglycemia”[Mesh] OR “Obesity, Abdominal”[Mesh] OR “Obesity”[Mesh] OR “Hypertension”[Mesh] OR “Metabolic Syndrome X”[Mesh] OR “Overweight”[Mesh] OR “Body Mass Index”[Mesh] OR “Body Weight”[Mesh] OR “Sagittal Abdominal Diameter”[Mesh] OR “Self Care”[Mesh] OR “Health Knowledge, Attitudes, Practice”[Mesh] OR “Quality of Life”[Mesh]) NOT “Diabetes, Gestational”[Mesh] NOT “Animal Experimentation”[Mesh] NOT “Diabetes Mellitus, Type 1”[Mesh]
Embase: #1: (‘prevention’/exp OR ‘yoga’/exp OR ‘tai chi’/exp OR ‘alternative medicine’/exp OR ‘primary prevention’/exp OR ‘occupational health’/exp); #2: (‘diabetes mellitus’/exp OR ‘impaired glucose tolerance’/exp OR ‘obesity’/exp OR ‘metabolic syndrome x’/exp) AND (‘prevention’/exp OR ‘yoga’/exp OR ‘tai chi’/exp OR ‘alternative medicine’/exp OR ‘primary prevention’/exp OR ‘occupational health’/exp); #3: (‘cohort analysis’/exp OR ‘cohort analysis’ OR [cochrane review]/lim OR [systematic review]/lim OR [meta analysis]/lim OR [controlled clinical trial]/lim OR [randomized controlled trial]/lim) AND (‘diabetes mellitus’/exp OR ‘impaired glucose tolerance’/exp OR ‘obesity’/exp OR ‘metabolic syndrome x’/exp); #4: ([english]/lim OR [portuguese]/lim OR [spanish]/lim) AND [adult]/lim AND [humans]/lim AND [2000-2017]/py AND [article]/lim AND ([embase]/lim OR [embase classic]/lim); #5: #1 AND #2 AND #3 AND #4
Web of Science: #1: (TS=(“Occupational Health” OR “Primary Prevention” OR “Occupational Health Services” OR “Preventive Health Services” OR “Complementary Therapies” OR “Integrative Medicine” OR “Models, Organizational” OR “Behavior Therapy” OR “Tai Ji” OR “Yoga” OR “Qigong”)); #2: (TS=(“diabetes” OR “Metabolic Syndrome” OR “Prediabetic State”)); #3: (TS=((“adult population” OR “Adult” OR “Occupational Groups” OR “Occupational Health Nursing” OR “Workplace” OR (“Occupational Groups” AND “Population”) OR “Work-related” OR “Worksite” OR “Working population” OR “Economically active population”))) AND LANGUAGE: (English OR Portuguese OR Spanish) AND DOCUMENT TYPES: (Article); #4: #1 AND #2 AND #3, Indexes=SCI-EXPANDED, SSCI, A&HCI, CPCI-S, CPCI-SSH, BKCI-S, BKCI-SSH, ESCI, CCR-EXPANDED, IC Timespan=2000-2017
CENTRAL: #1: MeSH descriptor: [Diabetes Mellitus, Type 2] explode all trees and with qualifier(s): [Prevention & control - PC]; #2: MeSH descriptor: [Workplace] explode all tres; #3: #1 AND #2; Publication Year from 2000 to 2017
Lilacs: (tw:(DIABETES)) AND (tw:(PREVENTION)) AND (tw:(WORKPLACE))

Reference	Country	Intervention - - Program	Study design	Follow-up (months)	Risk factor	Population	Field of work
Limaye et al. ²⁵ (2016)	India	LSI 2 - NICE	Randomized Trial	12	≥ 3 cardiometabolic risk factors	265 participants: 132 in the control and 133 in the intervention group, with a mean of 36.2 years of age (SD = 8.0), being 75% male.	Computer science
Kramer et al. ¹⁹ (2015)	USA	LSI 1 - DPP	Randomized Trial	12	Pre-diabetes, BMI ≥ 24, MS or hyperlipidemia	89 participants: 60 individuals in the first group (advanced) and 29 in the second (late), with an average age of 52.3 years old (range: 34–70), being 45% male.	Pharmaceutical company
Weinhold et al. ²⁰ (2015)	USA	LSI 1 - DPP	Randomized Trial	07	Pre-diabetes + BMI ≥ 25	69 participants (34 in control and 35 in intervention) from 18 and 65 years old, being 20% male.	University employees
Faghri et al. ²¹ (2014)	USA	LSI 1 - DPP	Randomized Trial	07	Risk Score (DRS) + BMI ≥ 25	99 participants: 51 in the group with incentive and 48 in the group without incentive. Average age of the group without and with incentive: 48.98 (SD = 11.23) and 45.14 (SD = 11.27) years old, respectively.	Nursing Technicians
Maruyama et al. ²⁴ (2010)	Japan	LSI 1 - LiSM10!	Randomized Trial	04	MS	87 male participants: 49 in the control group and 52 in the intervention group, with an average of 52.0 (SD = 7.9) years old.	Clerks
Watanabe et al. ²⁶ (2003)	Japan	Nutritional - JDS/ADA	Randomized Trial	12	Pre-diabetes	173 male participants: 77 in the control group and 79 in the intervention group, with an average of 55 years old.	Not specified
Zyriax et al. ²² (2014)	Germany	LSI 1 - FDPS	Pre- and post-test study	36	Large abdominal circumference + pre-diabetes	300 participants with an average age of 43.6 years old. Participants at DM2 risk and with DM2 diagnosis are evaluated separately.	Not specified
Viitasalo et al. ²³ (2015)	Finland	LSI 1 - FDPS	Pre- and post-test study	30	Risk score	1347 participants: 945 at low risk of DM2 and 402 at a high risk of DM2, with an average age in men and women of 50 (SD = 7.3) and 47 (SD = 8.0) years old, respectively.	Airline employees
Burton et al. ² (2015)	USA	LSI 1 - HLDP	Pre- and post-test study	12	Pre-diabetes	34 participants with pre-diabetes, 65 with diabetes and 2 with other risk factors. Participants at DM2 risk and with DM2 diagnosis are evaluated separately.	Financial services
Bevis et al. ²⁸ (2014)*	USA	LSI 2 - NR	Pre- and post-test study	12	Pre-diabetes	73 participants with pre-diabetes, with an average age of 50.0 (SD = 10.0) years old, being 74% male. Participants at DM2 risk and with DM2 diagnosis are evaluated separately.	Not specified

Reference	Country	Intervention - structure	Incentive	Employer’s role	Outcome	Rating
Limaye et al. ²⁵ (2016)	India	1 group session at the beginning and every 3 months.	NR	Enrollment	Significant reduction of body weight, BMI and abdominal circumference concerning the control group. Reduction of 6.0% in the prevalence of BMI ≥ 25 kg/m ² is reported in the intervention group, as well as a 6.8% increase in the control group. No reduction in the percentage of weight lost is reported.	Effective
Kramer et al. ¹⁹ (2015)	USA	12 weekly sessions for 3 months, 4 biweekly sessions for 3 months, and 6 monthly meetings of maintenance for 6 months.	Discount cards.	Work environment and schedules	Significant reduction in body weight, HbA1C, abdominal perimeter and BMI between the study groups at 6 months of intervention. Reduction of 5% of initial body weight by 45% in the first group and 7% in the second group at 6 months of intervention.	Effective
Weinhold et al. ²⁰ (2015)	USA	16 weekly sessions for 4 months.	NR	Work environment and schedules	Significant reduction in weight, BMI, abdominal circumference, and fasting glucose levels in the intervention group and concerning the control group. In the intervention and control group, 52.9% and 2.9% of the participants managed to lose at least 5% of body weight, respectively, in the post-intervention period.	Effective
Faghri et al. ²¹ (2014)	USA	16 60-minute sessions per week, for 4 months.	Cumulative economic incentive.	Enrollment	Significant reduction in weight and BMI in the group with economic incentive when compared to the group without economic incentive. No reduction in the percentage of weight lost is reported.	Effective
Maruyama et al. ²⁴ (2010)	Japan	1 session at the beginning of intervention, individual counseling for 2 months, and online counseling for the following 2 months.	NR	Enrollment	Significant reduction of 14 out of 17 parameters that define the risk of developing DM2, among which are weight and body mass index. No reduction in the percentage of weight lost is reported.	Effective
Watanabe et al. ²⁶ (2003)	Japan	1 session per month of study and 1 session at the sixth month of study, via e-mail.	NR	Not specified	Significant reduction in daily caloric intake, especially at night, with subsequent decrease in the 2-hour postprandial glucose levels when compared to the control group. No reduction in the percentage of weight lost is reported.	Effective
Zyriax et al. ²² (2014)	Germany	6 monthly sessions for 6 months, 6 biweekly sessions for 6 months, and 1 session every four months for 2 years.	NR	Enrollment	Significant reduction in weight, body mass index, and abdominal circumference. In men and women there was a reduction of 4.3 ± 3.6 and 3.6 ± 2.4 kg, respectively, in the post-intervention period. No reduction in the percentage of weight lost is reported.	Effective
Viitasalo et al. ²³ (2015)	Finland	Not specified.	NR	Enrollment	There was an increase in the risk of DM2, while in the high-risk group the reduction in DM2 risk was not significant. Reduction of ≥ 5% was reported in 20.8% of men and 7.0% of women who attended more than one session.	Uneffective
Burton et al. ²⁷ (2015).	USA	Not specified.	Glucometers and economic incentive when completing the study.	Wellness program	There was no significant reduction in Body Mass Index (BMI) during the study, which was shown at levels greater than 30 kg/m ² during the study. •No reduction in the percentage of weight lost is reported.	Uneffective
Bevis et al. ^28* (2014)	USA	4 2-hour educational sessions in the first semester and 8 subsequent telephone sessions.	Glucometers and affiliation in wellness program.	Wellness program	There was no significant reduction in BMI, which was greater than 35 kg/m ² during the study, nor was there a significant reduction in glycosylated hemoglobin levels (HbA1c). No reduction in the percentage of weight lost is reported.	Uneffective

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

[TFN1] LSI 1: conventional intervention (with a nutritional and physical activity approach); LSI 2: conventional intervention, with virtual monitoring and counseling; Nutritional: exclusively nutritional intervention; MS: metabolic syndrome; BMI: body mass index; DPP: Diabetes Prevention Program; FDPS: Finnish Diabetes Prevention Study; LiSM10!: Life Style Modification Program for Physical Activity and Nutrition Program; JDS/ADA: Japan Diabetes Society and American Diabetes Association; HLDP: Healthy Living with Diabetes Program; NR: Not reported. SD: Standard Deviation. DRS: Diabetic Retinopathy Study.