Global Challenge in Diabetes Prevention from Practice to Public Health

Abstract

The prevention of type 2 diabetes (T2D) is reaching its mature stages. First, research to establish the necessary database for the evidence-based prevention has accumulated large amount of data from observational studies around the world. Second, simple and efficient risk scores for screening for T2D risk have been developed and used in the public health setting. Third, randomised controlled trials have demonstrated that lifestyle intervention targeting to main modifiable risk factors for T2D in high-risk individuals is highly effective reducing the incidence of T2D by about 50%. Fourth, nationwide or regional T2D prevention programmes have been set up in order to translate the research findings to the real-life settings—Finland was the first country to establish such a programme 10 years ago followed by others. What is needed now is the implementation of the state of the art in diabetes prevention into population-based practice with adaptation into local conditions. The IMAGE project is a landmark project developing the state-of-the-art material for the implementation of diabetes prevention into practice. As output of the IMAGE project a practical toolkit for diabetes prevention together with an evidence-based guideline and a curriculum for prevention manager was developed. This needs to be implemented and can be achieved if network structures of international experts provide the background and support the implementation. What is needed now is political support to develop national action plans for diabetes prevention. The prerequisites for successful prevention activities include involvement of a number of stakeholders on governmental and nongovernmental level as well as on different levels of health care. Furthermore, structures to identify high-risk individuals and to manage intervention, follow-up and evaluation have to be established.