Long term effects of changes in lifestyle on glucose tolerance and adherence to the intervention program in subjects with impaired glucose tolerance

The 'Study on lifestyle intervention and Impaired glucose tolerance Maastricht (SLIM)' is an ongoing project in which the effect of a 3 y lifestyle intervention (healthy nutrition, increased physical actvity) is studied in subjects with impaired glucose tolerance (IGT) in the age of 40-65 y. The 1-year results show that this intervention is feasible in this group of Dutch subjects and that this intervention can reverse the worsening of glucose tolerance (decrease in 2-h glucose is 0.8 mM), promotes weight loss and improves physical fitness. The present proposal aims to obtain more information on the long term effects (3-6 y) of this intervention on glucose tolerance and on adherence to the intervention. If this program appears to be effective in improving glucose tolerance and cardiovascular risk, this leads to a more effective prevention of type 2 diabetes mellitus. Furthermore, it is intended to investigate to what extent the outcome depends on lifestyle factors (e.g. frequency of visits to sports school), metabolic factors (e.g. changes in body weight, and aerobic fitness) or genetic predisposition since this may provide information for a more targeted implementation of this intervention into the health care system. Also, we will assess the main factors associated with long term adherence. For large-scale implementation later on, this knowledge will provide indications for improving long term adherence.