Internal Med Medical News about type 2 diabetes; prevention

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Preventing type 2 diabetes: can we make the evidence work?
Postgraduate Medical Journal, 09/11/09

Yates T et al. – The prevention of type 2 diabetes is a public health priority. While several lifestyle intervention programmes have proven highly effective at reducing the progression to type 2 diabetes in individuals with prediabetes, important issues remain surrounding the applicability of such interventions to a primary health care setting. Effective and feasible methods of identifying and targeting individuals with a high risk of developing type 2 diabetes are therefore needed. Future results from several community based randomised controlled trials should help answer these questions in due course.

The prevalence of type 2 diabetes mellitus is increasing globally and represents a serious burden to national health care resources.
Type 2 diabetes is preceded by impaired glucose tolerance and/or impaired fasting glucose, collectively called prediabetes.
Type 2 diabetes and prediabetes are attributable to lifestyle factors.
Diabetes prevention programmes have consistently shown that lifestyle modification programmes can reduce the risk of developing type 2 diabetes by over 50% in individuals with impaired glucose tolerance.
Risk scores, rather prediabetes screening strategies based around 2 h post–challenge glucose and/or fasting glucose, may have greater clinical utility for classifying type 2 diabetes risk status in the general population.
Prevention strategies based around group based education may be suitable for implementation in a primary health care setting.

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