背景为寻找无需大量资金和人力便可在日常生活中实施的、预防糖尿病的有效策略,荷兰糖尿病协会为空腹血糖受损(IFG;根据WHO标准:空腹血糖6.1~6.9 mmol/L)者制定了健康生活方式持续改善指导计划:“糖尿病预防路径图”(以下称:路径图或RM)。该计划由全科医生和执业护士在从事基层医疗卫生服务的过程中施行。试验将对RM的可行性及经济有效性进行评价。方法与设计在进行全科诊疗的同时开展组群随机临床试验,对高危人群实施机会性筛查和主动病例搜索。一旦做出IFG诊断,鼓励患者接受1年内3~4次由执业护士提供的咨询,从而指导患者增加活动量并改善饮食习惯。必要时,将为受试者指派营养师、理疗师,或推荐生活方式改善项目和/或当地体育活动。对照组接受常规治疗。试验结果主要体现为体质指数(BMI)的变化,此外还体现为腰围、体力活动量、饱和脂肪总摄入量、收缩压、血糖、总胆固醇、高密度脂蛋白胆固醇、三酰甘油的测量水平及行为决定因素,如风险认知、对疾病的认知和治疗动机的改变。根据样本量计算结果,每组需包括120名受试者。在干预前进行结果测量作为比较基准,并分别于实施干预后1年和2年跟踪测量。通过有效的问卷调查,在诊疗、体力活动、进食及其行为决定因素改变的过程中,对体征及生化测量数据进行评估。利用慢性病模型(Chronic Disease Model,CDM)评估成本效益。在卫生保健专业人员中开展会谈检测可行性。讨论研究结果将为卫生保健专业人员和决策者提供有价值的信息。如果研究显示RM有效且具有成本效益,那么此计划便可推广使用。 Background In an effort to find an effective diabetes prevention strategy that can be implemented in daily life without significant financial and human resources, the Dutch Diabetes Association developed a plan for impaired fasting glucose (IFG; 6.1 to 6.9 mmol / L according to WHO criteria) Healthy Living Style Continues to Improve Mentoring Program: “Diabetes Prevention Path Map ” (hereafter: Pathmap or RM). The program is being run by GPs and nurse practitioners in primary health care services. The trial will evaluate the feasibility and economic effectiveness of RM. Methods and Design Randomized clinical trials of cohorts were conducted at the same time as general practice, and opportunistic screening and active case searching were conducted for high-risk groups. Once an IFG diagnosis is made, the patient is encouraged to receive counseling from a licensed nurse three or four times a year to guide the patient in increasing activity and improving eating habits. Subjects will be assigned dietitians, physiotherapists, or recommended lifestyle improvements and / or local sports activities where necessary. Control group received routine treatment. The test results mainly reflected the changes of body mass index (BMI), in addition to the waist circumference, physical activity, total saturated fat intake, systolic blood pressure, blood glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride levels And behavioral determinants, such as risk perception, cognition of disease and change of motivation of treatment. Based on the sample size calculations, each group should include 120 subjects. Outcome measures were taken prior to the intervention as a baseline and the measurements were followed 1 and 2 years after interventions were performed. Through valid questionnaires, signs and biochemical measurements were evaluated during the diagnosis, physical activity, eating, and changes in their behavioral determinants. Cost effectiveness is assessed using the Chronic Disease Model (CDM). Conduct talks among health care professionals to test for feasibility. Discussing the findings will provide valuable insights to health care professionals and decision makers. If the research shows that RM is effective and cost-effective, then the program can be promoted.