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Identifying Appropriate Strategies for Diabetes Prevention

Identifying Appropriate Strategies for Diabetes Prevention

Abbreviations: CVD > cardiovascular disease DPP > Diabetes Prevention Program FPG > fasting plasma glucose IFG > impaired fasting glucose IGT > impaired glucose tolerance NNT > number needed to treat OGTT > oral glucose tolerance test TRIPOD > Troglitazone in Prevention of Diabetes

American Diabetes Association Alert Day, observed every fourth Tuesday of March, on March 23 this year, is a part of a movement to create awareness about the ‘silent killer’ that more than 34.2 million Americans are at risk of.

Recent Clinical Practice Recommendations 2003 by American Diabetes Association have indicated that there are now interventions capable of delaying the onset of diabetes. Most of the diabetes prevention trials required that subjects have IGT (defined as an FPG level <140 mg/dl and a 2-h OGTT value between 140 and 199 mg/dl) as the main enrollment criterion.


The Strategies Effective in Preventing Diabetes Rely on :

The greater benefit of weight loss and physical activity strongly suggests that lifestyle modification should be the first choice to prevent or delay diabetes. Modest weight loss (5–10% of body weight) and modest physical activity (30 min daily) are the recommended goals. Because this intervention not only has been shown to prevent or delay diabetes, but also has a variety of other benefits, health care providers should urge all overweight or sedentary individuals to adopt these changes, and such recommendations should be made at every opportunity.


Drug therapy to prevent or delay diabetes appears to be much less beneficial for a variety of reasons.

Recommendations to Prevent or Delay Diabetes

* May not be correct for all ethnic groups.
Therefore, when all factors are considered, there is insufficient evidence to support the use of drug therapy as a substitute for, or routinely used in addition to, lifestyle modification to prevent diabetes. Until there are studies showing that drugs will delay or prevent the complications of diabetes, or until the cost-effectiveness of using pharmacological agents has been established, ADA does not recommend the routine use of these agents to prevent diabetes. For now it seems that, lifestyle intervention to prevent diabetes appears to be very safe, and, therefore, regular monitoring for untoward effects is unnecessary.

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