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Diabetes Prevention (diabetes + prevention)

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Medical Sciences	100%

Terms modified by Diabetes Prevention

diabetes prevention program

Selected Abstracts

Reflecting on Type 2 Diabetes Prevention: More Questions than Answers!

DIABETES OBESITY & METABOLISM, Issue 2007
J. Rosenstock
Given the enormous public health and economic burden posed by the global epidemic of type 2 diabetes mellitus (T2DM), intervention in the prediabetes stage of disease to prevent progression to T2DM and its vascular complications seems the most sensible approach. Precisely how best to intervene remains the subject of much debate. Prudent lifestyle changes have been shown to significantly reduce the risk of progression in individuals with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Although lifestyle modifications are notoriously difficult to maintain, there is evidence that intensive intervention results in continued preventive benefit after the stopping of structured counselling. A number of drug therapies, including metformin, acarbose, orlistat and rosiglitazone, have also been proven effective in preventing progression from IFG/IGT, but unresolved issues still remain. Specifically, whether large numbers of individuals with glucose dysregulation who may never progress to T2DM should be exposed to the risk of pharmacological adverse effects is a topic of discussion and debate. Furthermore, there are limited data on the effectiveness of implementing interventions during the prediabetic state to prevent cardiovascular complications that may be hyperglycaemia related. A recent American Diabetes Association (ADA) consensus statement on IFG/IGT recommends lifestyle modification for individuals with IFG or IGT. Of note, the ADA consensus statement introduces the option of adding metformin treatment to lifestyle changes in those individuals who have combined IFG/IGT plus an additional risk factor for progression and who also have some features that increase the likelihood of benefiting from metformin treatment. The dipeptidyl peptidase-4 inhibitors are a new class of oral antidiabetic agents that, in addition to being effective in improving glycaemic control, may exert beneficial effects in preserving ,-cell function. These characteristics, combined with a low risk of hypoglycaemia, weight neutrality and what appears , so far , to be a relatively benign tolerability profile, make these agents intriguing candidates for preventive treatment. [source]

Type 2 diabetes in families and diabetes prevention

EUROPEAN DIABETES NURSING, Issue 2 2008
FRCP Professor of Diabetic Molecular Medicine, M Walker MD
Abstract Type 2 diabetes frequently clusters in families. Non-diabetic first-degree relatives (offspring and siblings) of patients with type 2 diabetes have a three-fold increased lifetime risk of developing diabetes compared with the background population. This increased diabetes risk results from the combined effects of shared genetic and lifestyle factors. Extensive studies of non-diabetic relatives of type 2 diabetic families show that impaired insulin secretion, insulin resistance and an adverse cardiovascular risk factor profile exist well before the development of frank diabetes. Despite this well-documented adverse metabolic predisposition, patients with type 2 diabetes and their non-diabetic relatives generally have a limited understanding of the risks. Several large-scale studies, such as the Finnish Diabetes Prevention and Diabetes Prevention Program studies, indicate unequivocally that lifestyle modification through dietary change and exercise can dramatically decrease risk of progression to diabetes in high-risk subjects. However, such individuals pursue lifestyle changes only if they understand their own risk of developing diabetes. Further work is therefore needed to investigate and develop optimal ways of improving knowledge of diabetes risk in families of patients with type 2 diabetes, so that they can appreciate the potential benefits of diabetes prevention strategies. Copyright © 2008 FEND [source]

The role of renin,angiotensin,aldosterone system-based therapy in diabetes prevention and cardiovascular and renal protection

DIABETES OBESITY & METABOLISM, Issue 12 2008
Hussam Abuissa
Hypertension increases the risk of type 2 diabetes mellitus (T2DM) and cardiovascular disease. In addition to lowering blood pressure, blockade of the renin,angiotensin,aldosterone system (RAAS) reduces the risk of new-onset T2DM and offers renal protection. Using a MEDLINE search, we identified multiple trials that reported the incidence of T2DM in patients taking inhibitors of RAAS. In this review, we will discuss the RAAS as a potential target in diabetes prevention and the mechanisms through which inhibitors of this system achieve such an important effect. We will also shed light on the beneficial cardiovascular and renal effects of RAAS blockade. Although multiple studies have demonstrated that inhibitors of RAAS, especially angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, can reduce the incidence of T2DM, randomized controlled studies are still needed to further elucidate their exact role in diabetes prevention. [source]

The global challenge of type 2 diabetes and the strategies for response in ethnic minority groups

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 6 2010
Flavio Lirussi
Abstract Ethnic minorities living in high-income countries usually exhibit a greater risk of developing diabetes along with higher morbidity and mortality rates. We evaluated the effectiveness of interventions to improve glycaemic control in ethnic minority groups. Results of major controlled trials, systematic reviews and meta-analyses were included in the review. Only 1/47 studies addressing diet and exercise interventions reported details on the ethnicity of the studied population. Self-management education was successful if associated with increased self-efficacy; delivered over a longer period; of high intensity; culturally tailored; and when using community educators. Strategies adopted in community-gathering places, family-based, multifaceted, and those tackling the social context were likely to be more effective. A positive relationship was found between social support and self-management behaviour as well as quality of life, but there is little evidence about the impact of organizational changes within health-care services on diabetes control. More research is needed to strengthen the evidence on effective strategies for response to diabetes in ethnic minorities. Also, there is a need to take into account diabetes beliefs and communication difficulties, as well as potential protective factors. Globally, many health-care systems are inadequately equipped to improve diabetes prevention and disease outcomes in these communities. Copyright © 2010 John Wiley & Sons, Ltd. [source]

The DPT-1 trial: a negative result with lessons for future type 1 diabetes prevention

DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 4 2002
Professor Paolo Pozzilli
Abstract The author comments on the DPT-1 Trial and why the observed negative outcome in preventing diabetes in first-degree relatives of type 1 diabetic patients by parenteral insulin administration may have occurred and what can be gathered from this large study. There were three main lessons to be learned from the DPT-1 Trial as follows. (1) Large preventive trials of type 1 diabetes are feasible in first-degree relatives of type 1 diabetic patients and other preventive approaches may be now envisaged. (2) The natural history of type 1 diabetes, at least in its final years before clinical onset, has been elucidated and reiterates the relevance of our present predictive tools (autoantibodies) for identifying individuals at risk for the disease. (3) Strict follow-up of enrolled subjects in trials permits an earlier diagnosis of the disease with less frequency of ketoacidosis and implementation of insulin therapy when higher C-peptide levels are present. DPT-1 has paved the way on how to proceed and new trials will be planned benefiting from such experience. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Researching how to realize the potential of diabetes prevention

DIABETIC MEDICINE, Issue 10 2007
R. K. Simmons
No abstract is available for this article. [source]

International Diabetes Federation: a consensus on Type 2 diabetes prevention

DIABETIC MEDICINE, Issue 5 2007
K. G. M. M. Alberti
Abstract Aims, Early intervention and avoidance or delay of progression to Type 2 diabetes is of enormous benefit to patients in terms of increasing life expectancy and quality of life, and potentially in economic terms for society and health-care payers. To address the growing impact of Type 2 diabetes the International Diabetes Federation (IDF) Taskforce on Prevention and Epidemiology convened a consensus workshop in 2006. The primary goal of the workshop and this document was the prevention of Type 2 diabetes in both the developed and developing world. A second aim was to reduce the risk of cardiovascular disease in people who are identified as being at a higher risk of Type 2 diabetes. The IDF plan for prevention of Type 2 diabetes is based on controlling modifiable risk factors and can be divided into two target groups: ,,People at high risk of developing Type 2 diabetes ,,The entire population. Conclusions, In planning national measures for the prevention of Type 2 diabetes, both groups should be targeted simultaneously with lifestyle modification the primary goal through a stepwise approach. In addition, it is important that all activities are tailored to the specific local situation. Further information on the prevention of diabetes can be found on the IDF website: http://www.idf.org/prevention. [source]

Type 2 diabetes in families and diabetes prevention

From rural beginnings to statewide roll-out: Evaluation of facilitator training for a group-based diabetes prevention program

AUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 2 2010
Clare Vaughan
Abstract Objective:,To evaluate the approach used to train facilitators for a large-scale group-based diabetes prevention program developed from a rural implementation research project. Participants:,Orientation day was attended by 224 health professionals; 188 submitted the self-learning task; 175 achieved the satisfactory standard for the self-learning task and attended the workshop; 156 completed the pre- and post-training questionnaires. Main outcome measures:,Two pre- and post-training scales were developed to assess knowledge and confidence in group-based diabetes prevention program facilitation. Principal component analysis found four factors for measuring training effectiveness: knowledge of diabetes prevention, knowledge of group facilitation, confidence to facilitate a group to improve health literacy and confidence in diabetes prevention program facilitation. Self-learning task scores, training discontinuation rates and satisfaction scores were also assessed. Results:,There was significant improvement in all four knowledge and confidence factors from pre- to post-training (P < 0.001). The self-learning task mean test score was 88.7/100 (SD = 7.7), and mean assignment score was 72.8/100 (SD = 16.1). Satisfaction with training scores were positive and ,previous training' interacted with ,change in knowledge of diabetes prevention program facilitation' but not with change in ,confidence to facilitate.' Conclusions:,The training program was effective when analysed by change in facilitator knowledge and confidence and the positive mean satisfaction score. Learning task scores suggest tasks were manageable and the requirement contributed to facilitator self-selection. Improvement in confidence scores in facilitating a group-based diabetes prevention program, irrespective of previous training and experience, show that program-specific skill development activities are necessary in curriculum design. [source]

Cigarette smoking is an independent risk factor for type 2 diabetes: a four-year community-based prospective study

CLINICAL ENDOCRINOLOGY, Issue 5 2009
Nam H. Cho
Summary Objectives, We investigated the association between smoking and its additive effects with insulin resistance and ,-cell function on the incidence of type 2 diabetes in a prospective population-based cohort study. Design and method, A total of 10 038 subjects were recruited from rural and urban areas. All subjects underwent 75 g oral glucose tolerance tests and full biochemical assessments at baseline and during 4-year follow-up period. The final analysis was limited to 4041 men due to the low smoking rates in women. Results, The ex- and heavy current smokers had the highest incidence of diabetes of 12·5% and 11·1% respectively, compared with never-smokers (7·9%) during 4 years. After multivariate adjustment by Cox-proportional hazard model, ex- and current smokers reveal a relative risk of 1·60 (95% CI: 1·07,2·39), 2·06 (1·35,3·16, for <20 cigarettes/day) and 2·41 (1·48,3·93, for ,20 cigarettes/day) respectively compared with never smokers. The risk of new onset diabetes was the highest in those with low homeostasis model assessment for beta cell function (HOMA-,) and high homeostasis model assessment for insulin resistance (HOMA-IR) group in both smokers and never smokers. Conclusions, Smoking is an independent risk factor for type 2 diabetes mellitus and showed synergistic interaction with the status of low insulin secretion and high insulin resistance for developing diabetes. Given the high rates of smoking and growing burden of diabetes in the world, cessation of smoking should be considered as one of the key factors for diabetes prevention and treatment programmes. [source]