Four Opportunities to Prevent Diabetes and Coronary Heart Disease

Abstract

Starting with the North Karelia Project in Finland, continuing with the large community-based heart disease prevention trials in the United States,1,2 and organizing CardioVision 2020 in Olmsted County, Minnesota,3 I have been involved with heart disease prevention programs for 40 years. During that time period, the prevalence of type 2 diabetes in the United States increased by one-third, and it is predicted to increase even more.4 Because the disease more than doubles the risk of death from heart disease5 and now contributes significant population-attributable risk, I am excited to have added my perspective, and perhaps contributed to the control of diabetes, by accepting the role of guest editor of this Diabetes Spectrum From Research to Practice section. Randomized, clinical trials are prima facie evidence that type 2 diabetes can be prevented. I clearly remember a day in Helsinki more than 10 years ago, when I was teaching at the World Health Organization noncommunicable disease prevention seminar. Jaakko Tuomilehto, MD, PhD, the principal investigator of the Finnish Diabetes Prevention Trial took me aside and told me that their results would be coming out in the New England Journal of Medicine . The publication of this landmark study6 was followed about a year later by the report of the larger, American Diabetes Prevention Program.7 The …