This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Nathan, D. M Search for Related Content Social Bookmarking                         What's this?

Preventing type 2 diabetes: what have we learned?

Massachusetts General Hospital, Diabetes Center, 50 Staniford Street, Boston, MA 02114, USA, dnathan{at}partners.org

The substantial burden of morbidity and mortality associated with type 2 diabetes and the high costs associated with the management of diabetic complications highlight the need for the development of strategies for the prevention of diabetes. Impaired glucose tolerance is a pre-diabetic state which may present an opportunity for intervention to prevent the onset of clinical diabetes. Four recent clinical trials, the DPP, the FDPS, the STOP-NIDDM and the Da Qing study, have evaluated interventions based on diet and exercise and/or pharmacotherapy in pre-diabetic subjects. In all these trials the intervention strategies significantly reduced the incidence of diabetes. A worldwide epidemic of type 2 diabetes will occur over the coming decades and translating the results of these studies into practical and effective initiatives for diabetes prevention is an urgent clinical priority. Br J Diabetes Vasc Dis 2003;3(suppl 1):S6—S11

Key Words: impaired glucose tolerance • type 2 diabetes • metformin • diabetes prevention.

References

• Harris MI, Flegal KM, Cowie CC et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998;21:518-24.[Abstract]
• Bloomgarden ZT International Diabetes Federation meeting, 1997. Type 2 diabetes: its prevalence, causes, and treatment. Diabetes Care 1998; 21:860-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Nathan DM Long-term complications of diabetes mellitus. N Engl J Med 1993;328:1676-85.[Free Full Text]
• Diabetes Health Economic Study Group 1997. The economics of diabetes and diabetes care: a report of the diabetes health and economic study. International Diabetes Federation: 1997.
• Köhler C., Temelkova-Kurktschiev T., Schaper F. et al. Prevalence of newly diagnosed type 2 diabetes, impaired glucose tolerance and abnormal fasting glucose in a high risk population. Data from the RIAD study using new diagnostic criteria for diabetes. Dtsch Med Wochenschr 1999;124:1057-61.[Medline] [Order article via Infotrieve]
• Edelstein SL, Knowler WC, Bain RP et al. Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studies. Diabetes 1997;46:701-10.[Abstract]
• Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346:393-403.[Abstract/Free Full Text]
• Tuomilehto J., Lindstrom J., Eriksson JG et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001;344:1343-50.[Abstract/Free Full Text]
• Chiasson JL, Josse RG, Gomis R. et al. Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 2002;359: 2072-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Pan XR, Li GW, Hu YH et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care 1997;20:537-44.[Abstract]
• Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 1997;20:1183-97.[Web of Science][Medline] [Order article via Infotrieve]
• Diabetes Prevention Program Research Group. The Diabetes Prevention Program: baseline characteristics of the randomized cohort. Diabetes Care 2000;23:1619-29.[Abstract/Free Full Text]
• Cusi K., DeFronzo RA Metformin: a review of its metabolic effects. Diabetes Rev 1998;6:89-130.
• World Health Organisation. Diabetes mellitus. Report of a WHO Study Group. World Health Organ Tech Rep Ser 1985;727:1-113.[Medline] [Order article via Infotrieve]
• McAuley KA, Williams SM, Mann JI et al. Intensive lifestyle changes are necessary to improve insulin sensitivity: a randomised controlled trial. Diabetes Care 2002;25:445-52.[Abstract/Free Full Text]
• Reaven G. Syndrome X. Curr Treat Options Cardiovasc Med 2001;3: 323-32.[Medline] [Order article via Infotrieve]
• Chisholm DJ, Campbell LV, Kraegen EW Pathogenesis of the insulin resistance syndrome (syndrome X). Clin Exp Pharmacol Physiol 1997;24: 782-4.[Web of Science][Medline] [Order article via Infotrieve]
• Gabir MM, Hanson RL, Dabelea D. et al. The 1997 American Diabetes Association and 1999 World Health Organisation criteria for hyperglycemia in the diagnosis and prediction of diabetes. Diabetes Care 2000;23:1108-12.[Abstract/Free Full Text]
• de Vegt F., Dekker JM, Jager A. et al. Relation of impaired fasting and postload glucose with incident type 2 diabetes in a Dutch population: The Hoorn Study. JAMA 2001;285:2109-13.[Abstract/Free Full Text]
• Harris MI, Eastman RC, Cowie CC et al. Comparison of diabetes diagnostic categories in the U.S. population according to the 1997 American Diabetes Association and 1980-1985 World Health Organization diagnostic criteria. Diabetes Care 1997;20:1859-62.[Abstract]
• Hu G., Qiao Q., Silventoinen K. et al. Occupational, commuting, and leisure time physical activity in relation to risk for type 2 diabetes in middle-aged Finnish men and women. European Association for the Study of Diabetes, 2002; A214.
• Stern MP, Fatehi P., Williams K., Haffner SM Predicting Future Cardiovascular Disease: Do we need the oral glucose tolerance test? Diabetes Care 2002;25:1851-6.[Abstract/Free Full Text]
• American Diabetes Association and National Institute of Diabetes, Digestive and Kidney Diseases. The Prevention or Delay of Type 2 Diabetes. Diabetes Care 2002;25:742-9.[Free Full Text]
• Goldhaber-Fiebert JD, Goldhaber-Fiebert SN, Tristan ML, Nathan DM Randomised controlled community-based nutrition and exercise intervention improves glycemia and cardiovascular risk factors in type 2 diabetic patients in rural Costa Rica. Diabetes Care 2003;26:24-9.[Abstract/Free Full Text]
• Palmer AJ, Roze S., Comte S., Cabrières L. Cost-effectiveness of intensive lifestyle changes or metformin in overweight, glucose-intolerant patients: modelling the long-term implications of the diabetes prevention program in the French, German and UK settings. Diabetologia 2002;45(suppl 2):A303.

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 1 suppl, S6-S11 (2003)
DOI: 10.1177/14746514030030010301


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Nathan, D. M Search for Related Content Social Bookmarking                         What's this?