Association of a multiple risk factor assessment and intervention program with risk of diabetes: A population-based matched cohort study
4 affiliations
- 1Department of Public Health and Caring Sciences, Clinical Geriatrics, Uppsala University, Uppsala, Sweden
- 2Department of Medical Sciences, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
- 3School of Sport Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
- 4Department of Diagnostics and Intervention, Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
Abstract
Background: Type 2 diabetes incidence remains high among older adults and contributes substantially to morbidity and healthcare burden. Most evidence supporting diabetes prevention derives from intensive lifestyle interventions targeting high-risk individuals under controlled trial conditions. The effectiveness of low-intensity, population-based prevention programs embedded in routine care remains uncertain. We evaluated whether participation in a comprehensive health assessment and counseling program was associated with reduced incidence of diabetes in older adults. Methods and findings: We conducted a population-based matched cohort study including 70-year-old residents of Umeå municipality, Sweden, enrolled between 2012 and 2022 and followed through December 2022. The intervention consisted of a comprehensive health assessment followed by individualized motivational counseling, without structured long-term follow-up. Participants were matched 1:10 to controls from the general Swedish population by birth year, sex, and educational level. Individuals with prevalent diabetes were excluded. The primary outcome was incident diabetes, defined as a first recorded diagnosis in specialist care and/or first dispensed glucose-lowering medication, identified through nationwide health and prescription registers. Conclusions: In this population-based cohort study, participation in a low-intensity preventive health program delivered in routine care was associated with a lower incidence of diabetes among older adults. However, the observational study design limits evidence on the intervention’s role in the observed association, and more robust evidence is needed. Nevertheless, these findings suggest that scalable, population-wide prevention strategies may complement intensive high-risk approaches in addressing diabetes in aging populations. Why was this study done?: What did the researchers do and find?: What do these findings mean?: In this population-based study, Ernst Bergman and colleagues found that older adults who participated in a health assessment followed by a personalized counselling session were less likely to develop type 2 diabetes than matched non-participants. These results suggest that a low-intensity intervention embedded in primary care may help support diabetes prevention in ageing populations.
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BibTeX
@article{bergman2026association,
title = {{Association of a multiple risk factor assessment and intervention program with risk of diabetes: A population-based matched cohort study}},
author = {Ernst Bergman and Anna Nordström and Lars Nyberg and Peter Nordström},
journal = {PLOS Medicine},
year = {2026},
month = sep,
doi = {10.1371/journal.pmed.1005043},
url = {https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005043},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of a multiple risk factor assessment and intervention program with risk of diabetes: A population-based matched cohort study
AU - Ernst Bergman
AU - Anna Nordström
AU - Lars Nyberg
AU - Peter Nordström
PY - 2026
DA - 2026/09/21
JO - PLOS Medicine
DO - 10.1371/journal.pmed.1005043
UR - https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1005043
AB - Background: Type 2 diabetes incidence remains high among older adults and contributes substantially to morbidity and healthcare burden. Most evidence supporting diabetes prevention derives from intensive lifestyle interventions targeting high-risk individuals under controlled trial conditions. The effectiveness of low-intensity, population-based prevention programs embedded in routine care remains uncertain. We evaluated whether participation in a comprehensive health assessment and counseling program was associated with reduced incidence of diabetes in older adults. Methods and findings: We conducted a population-based matched cohort study including 70-year-old residents of Umeå municipality, Sweden, enrolled between 2012 and 2022 and followed through December 2022. The intervention consisted of a comprehensive health assessment followed by individualized motivational counseling, without structured long-term follow-up. Participants were matched 1:10 to controls from the general Swedish population by birth year, sex, and educational level. Individuals with prevalent diabetes were excluded. The primary outcome was incident diabetes, defined as a first recorded diagnosis in specialist care and/or first dispensed glucose-lowering medication, identified through nationwide health and prescription registers. Conclusions: In this population-based cohort study, participation in a low-intensity preventive health program delivered in routine care was associated with a lower incidence of diabetes among older adults. However, the observational study design limits evidence on the intervention’s role in the observed association, and more robust evidence is needed. Nevertheless, these findings suggest that scalable, population-wide prevention strategies may complement intensive high-risk approaches in addressing diabetes in aging populations. Why was this study done?: What did the researchers do and find?: What do these findings mean?: In this population-based study, Ernst Bergman and colleagues found that older adults who participated in a health assessment followed by a personalized counselling session were less likely to develop type 2 diabetes than matched non-participants. These results suggest that a low-intensity intervention embedded in primary care may help support diabetes prevention in ageing populations.
SN - 1549-1676
ER -