STRATEGIES AND METHODS FOR IMPLEMENTING A COMMUNITY-BASED DIABETES PRIMARY PREVENTION PROGRAM IN SWEDEN

Non-insulin-dependent diabetes mellitus (NIDDM) is the most common typ e of diabetes with a prevalence of at least 4% in Sweden. There is con vincing evidence that, besides a genetic predisposition, exogenous fac tors such as poor dietary habits (high fat, low fibre content), low ph ysical activity and obesity are serious risk factors for NIDDM. Steps have been taken to develop a primary prevention program for NIDDM in S tockholm, Sweden. The program aims to reduce the incidence of NIDDM by 25% over a 10-year period, by influencing the risk factors in the pop ulations of three intervention municipalities. The intervention will b e developed through two approaches: 'community intervention', and 'int ervention within community'. Evaluation of the program will be perform ed by monitoring the prevalence and incidence of diabetes in the targe t population and by assessing the effects of strategies designed to in crease physical exercise and improve diet. Furthermore, changes in awa reness, knowledge, attitudes and practices related to prevention of di abetes, will be investigated. For this purpose, a baseline study is ca rried out in the three intervention municipalities and two selected co ntrol municipalities. The baseline study includes a sample of about 32 00 men and the same number of women, aged 35-54 years, from interventi on and control populations. A follow-up study after 5 and 10 years wil l be made.